Endocrine Abstracts

Introduction: The pituitary non-secreting microadenomas (or incidentalomas) are frequently diagnosed over the last decades thanks to imagery scan progresses and access. The gonadal dysfunction, as well as other pituitary deficiency is related to common genetic backup (+/− other pituitary dysfunctions) or may be incidental.

Aim: We analyzed the endocrine profile in pituitary incidentalomas (microadenomas).

Material and method: A retrospective study was performed in patients evaluated by computed tomography or magnetic resonance, and by the endocrine profile, and confirmed with pituitary incidentalomas at C.I.Parhon National Institute of Endocrinology, Bucharest, since 1994 up to present. The exclusion criteria were age <14 years.

Results: 236 cases of non-functioning adenomas of <1 cm diameter were included. The female:male ratio was 13.7. Average age at diagnosis of the tumor was 40.9 years. The endocrine profile indicated mean IGF1 levels of 223.8±79.1 ng/ml (normal<240 ng/ml). The minimum GH level during the oral glucose tolerance test was 0.2±0.5 ng/ml. The mean serum prolactin was 11.16±8.4 ng/ml (normal<20 ng/ml). One fifth of the patients needed or were under levothyroxin therapy (with primary hypothyroidism). 0.8% of the cohort had persistent hypogonadotropic hypogonadism (no specific genetic tests were performed). 2.4% of the patients associated partial GH deficiency, and 2.4% had partial adrenal secondary insufficiency. No correlation between tumors size and the endocrine disturbances was found. The age of diagnosis in patients with hypogonadotropic hypogonadism was statistically significant lower than the patients without endocrine disturbances and pituitary incidentalomas (P<0.05).

Discussions: Gene defects but also autoimmune disturbances might underlie pituitary deficiency. In any of these cases the imagery scan may provide microadenoma aspects.

Conclusion: The pituitary incidentaloma might be associated with pituitary deficiency in <3% in a population aged over 14 years that was not previously preselected based on the clinical endocrine phenotype.