ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Clinical parameters to distinguish silent corticotroph adenomas from other non-functioning pituitary adenomas
Daham Kim 1 , Cheol Ryong Ku 1 , Se Hee Park 1 , Kyeong Hye Park 2 , Ju Hyung Moon 3 , Eui Hyun Kim 3 , Sun Ho Kim 3 & Eun Jig Lee 1
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea; 3Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Silent corticotroph adenomas (SCAs) are difficult to distinguish from other non-functioning pituitary adenomas (NFPAs) preoperatively. This study assessed the preoperative clinical parameters associated with SCAs. After excluding patients with increased 24-h urinary free cortisol, 341 patients who underwent surgery for NFPAs during 2011–2016 with available preoperative combined pituitary function test (CPFT) and immunohistochemical staining results were enrolled. The patients’ medical records were retrospectively reviewed. The age and tumour size were similar between patients with SCAs and other NFPAs. The percentages of female patients (89.2 vs. 57.6%, P<0.001), cavernous sinus invasion (35.1 vs. 20.7%, P=0.047), and intra-tumoural haemorrhage on preoperative sella magnetic resonance imaging (32.4 vs. 9.2%, P<0.001) were higher in the SCA group. In the preoperative CPFT, the peak adrenocorticotropic hormone (ACTH) (67.80±49.83 vs. 85.67±78.97 pg/mL, P=0.061) tended to be lower, and the ΔACTH (53.71±50.14 vs. 72.67±75.82 pg/mL, P=0.046) was significantly lower in SCAs. After excluding patients with preoperative hypopituitarism caused by mass effects, the peak ACTH (69.39±39.45 vs. 119.75±89.84 pg/mL, P=0.001) and ΔACTH (58.58±36.51 vs. 107.66±86.05 pg/mL, P=0.001) were significantly lower in SCAs. Female sex, cavernous sinus invasion, intra-tumoural haemorrhage on sella magnetic resonance imaging, and decreased ACTH response are independent indicators of SCAs.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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