Endocrine Abstracts

Background: An “empty sella” is characterised by a sella turcica filled with cerebrospinal fluid. It is called primary when the empty sella is not linked to any pathological process of the pituitary itself. The prevalence of empty sella has been reported in up to 38% of imaging studies. Some patients may present with endocrine, neurological and ophthalmological symptoms due to the aberrant anatomy of the sellar region. The aim of this study was to analyse clinical presentation, hormonal function and subgroups of the studied primary empty sella population. A second goal was to examine brain imaging and investigate if an association exists between the degree of severity of empty sella and hormonal dysfunction in the examined patients.

Methods: A search-query for “empty sella” was executed throughout the medical records of the university hospital of Brussels for the period from January 2007 to September 2017. Patients with primary empty sella (PES) were selected and basic patient characteristics, hormonal laboratory results and brain imaging were retrospectively analysed. Patients were divided into a moderate and severe PES group, according to pituitary height loss.

Results: One-hundred-thirty-six patients with PES were included. Hormonal dysfunction was observed in 14.7% of the studied population. Growth hormone deficiency and secondary hypogonadism were the most prevalent hormonal dysfunctions in the studied population. These hormonal abnormalities were more frequent in patients with a severe PES compared to patients with a moderate PES. A statistically significant difference was not demonstrated.

Conclusion: A trend was observed between the degree of severity of PES and the occurrence of some hormonal abnormalities. Since hormonal dysfunction did not exclusively occur in patients with severe PES, we suggest that all PES patients should be clinically evaluated and assessed for hormonal dysfunction by an endocrinologist. Further research is needed to define a clear radiological cut-off for empty sella.