ECE2019 Guided Posters Anterior and Posterior Pituitary (12 abstracts)
Characteristics and natural history of a large cohort of non-functioning pituitary incidentalomas: a two-centers study
Nazarena Betella 1 , Alberto Tresoldi 1 , Giulia Carosi 2 , Giulia Del Sindaco 2 , Marco Locatelli 3 , Gherardo Mazziotti 1, , Davide Milani 5 , Elena Morenghi 6 , Anna Spada 7 , Maura Arosio 2, , Giovanna Mantovani 2, & Andrea Lania 1,
1Endocrine Unit, Humanitas Research Hospital, Rozzano, Italy; 2UO Endocrinologia e Diabetologia, Fondazione IRCCS Ca’ Granda, Milano, Italy; 3UO Neurochirurgia, Fondazione IRCCS Ca’ Granda, Milano, Italy; 4Dept of Biomedical Sciences, Humanitas University, Rozzano, Italy; 5UO Neurochirurgia, Humanitas Research Hospital, Rozzano, Italy; 6UO Biometria, Humanitas Research Hospital, Rozzano, Italy; 7University of Milan, Milano, Italy; 8Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy.
Context: Available data on the natural history of pituitary incidentalomas (PI) are not strong enough to draw any evidence-based conclusion on timing and length of follow up of these masses, due to heterogeneity and low sample sizes.
Objective: To describe the characteristics and the natural history of PI using data from a large cohort of patients investigated in two Italian Pituitary Centers.
Patients and methods: Retrospective study on patients diagnosed with PI with imaging characteristics and/or histology compatible with non-functioning pituitary adenoma between 1980 and 2018.
Results: 371 patients were included (microadenomas 50.9%, males 35.6%). Men were older and were more likely to have a macroadenoma at diagnosis (P < 0.01). At the first hormonal evaluation, hypopituitarism was present in 23.7% of patients, with a higher percentage of deficit in males, older patients and macroadenomas. Follow up data were available for 294 patients; 86 (29.2%) required surgery after first evaluation; 208 patients were initially managed conservatively. During follow up, 14.7% adenomas increased in size (more macroadenomas). 5.2% of patients developed new deficits (4.8% micro and 5.3% macro; more males); 7 of 10 patients showed a deterioration of pituitary function not associated with an increase in the size of the adenomas. 14 additional patients (6.7%) required surgery during follow up (1 microadenoma), bringing the number of patients requiring surgery to 100 (34.1%).
Conclusion: Size at diagnosis ≥10 mm, male gender and age are risk factor for hypopituitarism in pituitary incidentalomas at diagnosis; a pituitary deficit is present in more than 1 in 5 patients, underlying the importance of correct evaluation at baseline in these patients. During follow up, macroadenomas tend to grow more often; however, deterioration of pituitary function occurs in both micro and macroadenomas, and it is not always related to a change of the size of the adenoma. Overall, a third of patients requires surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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