Endocrine Abstracts

Objective: Tumors of the pituitary gland and sellar region, called pitiutary adenoma (PA) represent approximatly 10% of all central nervous system tumors. The characteristics of these tumors may vary from population to population.

Aim: The aim of this retrospective study was to investigate and understand the clinicopathological characteristics, the invasiveness, tumor features and clinical symptoms of PA in adult patients at south great plain region of Hungary.

Design and methods: Totally, 275 patients were retrospectively reviewed from 2007 to 2017. At 171 cases the pathological diagnosis was pituitary adenoma. Patients were periodically followed up at the Department of Neurosurgery and 1st Department of Medicine, University of Szeged, Clinical Center. Data of general information, clinical symptoms, invasive behaviors, surgery approaches, adenoma type by immunhistochemistry and adenoma relapses were collected and analyzed. All patients underwent transsphenoidal approach: total of 83 (48.53%) males and 87 females (50.87%) were diagnosed as pituitary adenoma with the mean age of 52.1 and 53.7 years, respectively. The main clinical manifestations were visual defects, headache and hormonal abnormalities such as increased growth hormone (GH), prolactin (PRL) and adrenocorticotropic hormone (ACTH), respectively. Among the patients with firm adenomas 21.63% had hypopituitarism.

Results: Based on the WHO 201 classification of pituitary adenomas, the types of adenoma in the investigated region were the following: 53% non-functioning null cell adenoma. Among the hormonally active adenomas 22% was somatotroph, 9-9% lactotroph and plurihormonal and 7% corticotroph. Interestingly, the adenoma recurrence was observed not in null cell adenomas; 41.6% relapse was detected in ACTH producing type.

Conclusion: Detailed clinical, hormonal and pathological evaluation is essential for better understanding the nature of adenoma growth and its progression. This study is the first at this region which overview the PA from endocrinological, neurosurgical and pathological aspects together. Specialized care and teamwork of endocrinologists, neurosurgeons, pathologists are equally important during treatment planning.