Clinical features of pituitary adenomas in elderly patients in Castilla La Mancha (Spain) compared with younger age group; a retrospective multicentre study

Almudena Vicente; Florentino Del Val; Claudia Cortes; Cristina Lamas; Miguel Aguirre; Julia Silva; Moubarak Alramadan; Ivan Quiroga

doi:10.1530/endoabs.37.EP737

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Endocrine Abstracts (2015) 37 EP737 | DOI: 10.1530/endoabs.37.EP737

ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)

Clinical features of pituitary adenomas in elderly patients in Castilla La Mancha (Spain) compared with younger age group; a retrospective multicentre study

Almudena Vicente ¹ , Florentino Del Val ¹ , Claudia Cortés ¹ , Cristina Lamas ² , Miguel Aguirre ³ , Julia Silva ⁴ , Moubarak Alramadán ⁵ & Iván Quiroga ⁶

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¹Department of Endocrinology and Nutrition, Hospital Virgen de la Salud, Toledo, Spain; ²Department of Endocrinology and Nutrition, Hospital General Universitario, Albacete, Spain; ³Department of Endocrinology and Nutrition, Hospital General Universitario, Ciudad Real, Spain; ⁴Department of Endocrinology and Nutrition, Hospital General La Mancha-Centro, Ciudad Real, Spain; ⁵Department of Endocrinology, Hospital Virgen de la Luz, Cuenca, Spain; ⁶Deparment of Endocrinology, Hospital Nuestra Señora del Prado, Talavera, Spain.

Background: Pituitary adenomas (PAs) in the elderly, defined as people older than 65 years, represent less than 10% of all PAs. Because of increasing life expectancy and improving health care, diagnosis PAs in this age group is increasing with time. Age-related changes and associated diseases may significantly modify the clinical presentation in these patients, delaying the diagnosis of PAs.

Objective: To analyse the clinical features of PAs in elderly patients in a study population from Castilla – La Mancha (Spain).

Design: Retrospective observational study.

Methods: The study included 346 patients with a presumptive diagnosis of pituitary adenoma between 2000 and 2012. Review of medical records of elderly patients with PAs was carried out.

Results: 67 patients, 19.4% of whole PAs, were studied (62.7% women). Mean age was 73 years (range 65–87). At presentation, visual impairment, headache and deficiency of ≧1 pituitary axes were detected respectively in 43.3, 47.6 and 50.8% of the patients with available data. There were statisti-cally significant differences in visual impairment (43.3% vs 16.3%, P<0.001), deficiency of ≧1 pituitary axes (50.8% vs 30.5%, P<0.001), incidental diagnosis (47.8% vs 14.9%, P<0.001) or pituitary apoplexy (10,4% vs 1%, P<0.001) between elderly and younger patients at presentation. 59 (88,1%) out of 67 patients had macroadenomas whereas 8 (11.9%) had microadenomas. Mean size of PAs in elderly patients was significantly greater than non elderly patients (23.9±12±0 mm vs 15.2±12.4 mm, P<0.001). 58 (86.8%) were non-functioning pituitary adenomas, 3 (4.5%) prolactinomas, and 6 (8.9%) GH-secreting adenoma. There was none ACTH – secreting adenoma.

Conclusions: The proportion of elderly patients in our study is higher than in other studies. Our data show that there are age-related differences in PAs clinical features at diagnosis. Visual impairment, hypopituitarism, incidental diagnosis, pituitary apoplexy and larger size are more frecuent features in elderly patients than in their younger counterparts. Most of PAs in elderly patients are macroadenomas and clinically non-functioning.