Endocrine Abstracts

Introduction: Non-functioning pituitary adenomas are relatively common. A large number of these tumors are asintomathic pituitary microadenomas, that are increasingly detected because of sensitive imaging techniques improves. Those tumors that require treatment are generally macroadenomas and come to medical attention because of mass effect (visual field defects, headache, …) and/or hypopituitarism.

Objective: To assess non-functioning pituitary adenomas (NFPAs) clinical features and natural history at our hospital.

Patients and methods: All patients with pituitary incidentalomas on brain imaging between 2010 and 2018 were reviewed. The referral source, principal symptom, MRI scan findings, visual field defects, pituitary function and imaging evolution were analysed.

Results: Twenty three patients were analized (15 women (65.2%); age 46.1±17 years). Most patients (85.7%) were diagnosed by magnetic resonance imaging (MRI.) 56.5% (n=13) were macroadenomas. Microadenomas were more common in women (43% vs 0%, P<0.05). About 36.4% of patients showed visual field defects (all of them macroadenomas); of these 6 (75%; P=0.003) were acompained by suprasellar extension. Invasion of the cavernous sinuses was present in 13.6% (n=3). Hypopituitarism was present in 4 (17.4%) patients. 7 patients (35%) underwent surgery (all of them macroadenomas). Our patients were evaluated after a median follow-up of 4.78 years by control MRI. In those whom surgical treatment was not performed, no significant changes were found in the maximum tumor diameter at the end of follow-up (9.53±6.18 vs 7.11±6.17 mm, NS). The majority of NFPAs evaluated did not show any changes in size.

Conclusions: The sample is too small to achieve significance but we can conclude that incidental NFPAs are diagnosed by MRI preferible from the 5th decade of life. Most of them are macroadenomas, more commonly diagnosed in men while microadenomas mostly appear in women. Suprasellar extension with chiasmatic compression are frequently related to visual field deffects. Hypopituitarism is not common at diagnosis. Most of the non-operated NFPAs remain with stable tumor size over time.

References: 1. Iglesias P 2017 Clinical features and natural history of clinically non-functioning pituitary incidentalomas. Presented at Society for Endocrinology ECE 2017, Lisbon, Portugal. Endocrine Abstracts 49.

2. Gill G 2015 Pituitary incidentaloma: features and outcomes: recent experience at a tertiary centre. Presented at Society for Endocrinology BES 2015, Edinburgh, UK. Endocrine Abstracts 38.