Endocrine Abstracts

Introduction

Non-functioning pituitary adenomas (NFPA) present approximately 15% to 30% of all pituitary adenomas. They are most commonly misdiagnosed, until they are large enough to lead to mass effect and hypopituitrasm. The present study was carried out with the aim of studying the clinical and biological characteristics of patients who are followed for NFA.

Patients and methods

This is a retrospective study of 35 patients presenting with NFPA, at the department of endocrinology at Hedi Chaker hospital Sfax-Tunisia, from January 2000 to December 2017.

Results

There were twenty males (57.14%) and fifteen (42.85%) females. The average age of patients was 49.23 years (16–75 years). The majority (48.57%) were aged between 40 and 60 years-old. Approximately 31.4% of patients were smokers. Headache was a major complaint for 28 patients (88%). Most of the patients reported to present moderate headache (57.14%, n = 16). Severe and mild headache were reported in 39.2% (n = 11) and 3.5% (n = 1), respectively. Holocranial headache was present in 32.1% of patients, followed by the bitemporal (35.7%) and frontal (9.5%) regions. Visual symptoms were identified in 74.28% of our study group. Blurring and progressive loss of vision were present in 53.8% and 73% of cases, respectively. Intracranial hypertension occurred in 6 cases (17.14%). Most tumors were macrodenomas, 32 (91.4%) vs 3(8.6%) microadenomas. Endocrine evaluation revealed central hypothyroidism in 34.28% of patients, presenting all a macroadenoma, with a mean level of thyroxine hormone (T4) and thyroid-stimulating hormone (TSH) of 6.95 pmol/l and 1.56 µUI/l, respectively. Adrenal insufficiency was observed in 37.65% of patients with a mean basal cortisol level of 56 µg/l. Prevalence of hypogonadotropic hypogonadism (HH) was 55% on males with a mean testosterone level of 1.12 ng/ml (range.0.02–2.8 ng/ml). On the other hand, 53.3% of the female group presented HH with an average level of oestradiol of 11.4 pg/ml (8–17.7 pg/ml). Disconnection hyperprolactinemia was found in 28.57% of patients with a mean value of 35.29 ng/ml.

Conclusion

NFPA present a heterogeneous group of pituitary tumors that range from being totally asymptomatic to inducing visual disorders and pituitary dysfunction secondary to mass effect. While NFPA are benign tumors, their management require treatment and regular monitoring and follow up.