ECE2016 Guided Posters Pituitary - Clinical (10 abstracts)
Natural history of a large cohort of pituitary incidentalomas in Italy
Alberto Stefano Tresoldi 1, , Alessandra Toini 3 , Eriselda Profka 2, , Marco Locatelli 4 , Giovanni Battista Lasio 5 , Emanuela Morenghi 6 , Anna Spada 2, , Giovanna Mantovani 2, & Andrea Gerardo Lania 1,
1Endocrinology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy; 2Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; 3Endocrinology and Diabetology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 4Neurosurgery Unit, Fondazione IRCCS Ca’ Granda, Milan, Italy; 5Neurosurgery Unit, Humanitas Research Hospital, Rozzano, Milan, Italy; 6Biometry Unit, Humanitas Research Hospital, Rozzano, Milan, Italy; 7Department of Biotechnologies and Translational Medicine, University of Milan, Milan, Italy.
In this observational, retrospective, multicenter study, we analyzed data from 300 patients with pituitary incidentaloma followed in two Italian Hospital Center. We observed a predominance of female patients (65%), with an a mean age at diagnosis of 49 years (higher in men than women, 57 vs 45 years old). The main reason to perform imaging were neurological symptoms not related to the presence of adenomas (56%). Most cases were microadenomas (56%), and macroadenomas were more frequent in males than females (75 vs 28%).
The first hormonal evaluation showed at least one pituitary deficiency in 21% of patients (35% of macroadenomas vs 10% of microadenomas). Hormonal follow up (median 3 years, range 0–27) showed a worsening in pituitary function in 7% of patients (7% of microadenomas vs 9% of macroadenomas). Radiological follow up (median 3 years, range 0–32) showed an increase of dimension in 27 patients (more frequent in macroadenomas, 33 vs 10%) and a reduction in 16% of cases. However, radiological and biochemical modification were concordant only in the 69% of patients; in six patients we witnessed a deterioration of pituitary function in presence of an adenoma stable or in reduction. Overall, 66 patients underwent surgery; in 58 cases surgical indication was formulated at diagnosis, while in eight patients during follow up due to growth of the lesion.
In our population, accordingly with the data available in literature, macroadenomas are more frequently found in males, and more prone to volumetric growth over time. Hormonal function is altered in about 1/5 of patients at diagnosis, with further deficit onset during the follow up; these changes are not always in agreement with radiological changes, remarking that, besides radiological assessement, a periodical biochemical follow up is also needed in these patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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