Endocrine Abstracts

Introduction: Pituitary adenomas are the most common cause of sellar masses. Several types of tumors may involve the sellar region, because of complex anatomy. They are classified according to size, function, immunohistochemical examination cell type of adenomas. Most of the pituitary adenomas without clinical function are gonadotropin-releasing adenomas on immunohistochemical examinations. They are usually seen as macroadenomas. They are often diagnosed with pituitary insufficiency due to adenomatous compression.

Case: A 68-year-old female patient presented with complaints of diplopia and narrowing of the visual field. There was no feature on her resume. No pathology was found on physical examination. A lesion consistent with a 39×30×25 mm adenoma was found on hypophysis MR. The adenomatous cavernous sinus lengthened and there was marked pressure on the optic chiasm. Bitemporal hemianopsy is present in the visual field examination. In laboratory tests panhypopituitarism was detected (Prolactine level is normal). Hormone replacement therapy started. The patient was operated under steroid replacement treatment. Visual function improved after the surgery. The histopathologic report showed an adenoma and immunohistochemical findings were consistent with gonodotropinoma.

Conclusion: In macroadenomas without clinical function, it is recommended to apply surgical treatment to visual field deficit or loss, ophthalmoplegia, optic chiasmal pressure, pituitary hormone deficiency and apoplexy. The aim of surgical treatment is to correct neurological deficits, hormone insufficiency and prevent recurrence.