ECE2019 Poster Presentations Pituitary and Neuroendocrinology 3 (73 abstracts)
Long term observation of patients with pituitary stalk lesions – single center experience
Łukasz Kluczyński 1, , Aleksandra Gilis-Januszewska 1, , Damian Rogoziński 1 , Jacek Pantofliński 1 , Katarzyna Żabicka 1 , Agata Zygmunt-Górska 3 , Małgorzata Wójcik 3 , Jerzy Starzyk 3 & Alicja Hubalewska-Dydejczyk 2,
1Endocrinology Department, University Hospital in Krakow, Krakow, Poland; 2Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; 3Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Insitute, Jagiellonian University, Medical College, Krakow, Poland; 4Endocrinology Department, University Hospital in Krakow, Kraków, Poland.
Background: Pituitary stalk lesions (PSL) are various changes located in the pituitary infundibulum. The underlying pathology and exact diagnosis are difficult to establish due to their difficult anatomical locus.
Aim: To present the etiological spectrum of pituitary stalk lesions and their clinical and hormonal characteristics on the basis of long term observation in the pediatric/adult endocrinology departments of our university.
Methods: A retrospective observational analysis of 28 patients (16M/12W) with pituitary lesions was performed. The mean age of diagnosis was 30.67 years (SD 23.93). The etiologies were divided into three groups (congenital, inflammatory, neoplastic) and classified as exact, probable or unknown.
Results: The most common causes of PSL were congenital malformations (14/28, 50.0%), an inflammatory etiology was found in 8/28 (28.6%), while neoplasms were diagnosed in 2/28 (7.1%) of patients. The exact etiology was established in 18/28 (64.3%) cases (14 congenital malformations, 2 histiocytosis, 1 Erdheim-Chester disease, 1 germinoma). The probable cause was suggested in 6/28 patients (21.4%) – five with the suspicion of lymphocytic hypophysitis and one with a metastatic tumor from a disseminated neuroendocrine cancer. The origin of 4/28 PSL (14.3%) remains unknown. During hormonal assessment the most common insufficiency concerned the thyroid axis found in 18/28 (64.3%) patients, followed by somatotropic (16/28, 57.1%), gonadal (14/28, 50.0%) and adrenal axis (13/28, 46.4% of cases) insufficiencies. 9/28 (32.1%) patients were diagnosed with diabetes insipidus. Some hormonal deficits were transient.
Conclusions: The diagnosis, management and treatment of the pituitary stalk lesions remains challenging. Difficulties in establishing the exact diagnosis might also be related to the non-specific, transient characteristics of the symptoms and hormonal insufficiencies. Long term observations might help better the understanding of the disease and result in improvement of management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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