Endocrine Abstracts

Introduction: Non-functional pituitary adenomas (NFPAs) represent 30% of all pituitary adenomas and not associated with clinical evidence of hormonal hypersecretion. The aim of our study was to describe the clinical and paraclinical aspects of NFPAs.

Methods: This is a retrospective descriptive study concerning 40 patients who were hospitalized in the endocrinology department of Rabta hospital in Tunis between January 2014 and December 2020. Clinical and paraclinical data were taken from medical records.

Results: Our population had a mean age of 51.8 ± 15.9 [21-80] years. Patients were 40% male and 60% female, sex ratio was 0.66. The circumstances of discovery were mainly: pituitary incidentaloma (12,5%), headache (50%), visual impairment (45%), endocrine manifestations (10%) and epilepsy (2,5%). Five had a pituitary apoplexy at the time of diagnosis (12.5%). On pituitary imaging, the mean size of the adenomas was 23 mm (4mm-52mm) and were classified: 4 microadenomas and 36 macroadenomas. The optic chiasm and pituitary stalk were invaded in 29 cases (72.5%), the cavernous sinus in 15 cases (37.5%) and the sphenoidal sinus in 6 cases (15%). The main symptoms were headache, visual impairment, asthenia, weight loss, psychomotor retardation and hypoglycaemic discomfort found in 27 (67.5%), 24 (60%), 21 (52.5%), 8 (20%), 7 (17.5%), 4 (10%) cases respectively. Decreased libido was found in 12 patients (30%). Seven women had secondary amenorrhea and 10 men had erectile dysfunction. Axillary-pubic depilation was noted in 5 persons. For the visual impact, an alteration of the visual field was found in 24 (60%) cases, a pathological fundus in 7 cases (17.5%), papilledema in 4 cases and optic atrophy for the rest. A decrease in visual acuity was observed in half of the subjects (50%). Hormonal deficiencies were corticotropic, thyrotropic, gonadotropic insufficiency, disconnection hyperprolactinemia and central diabetes insipidus in 80%, 32.5%, 42.5% and 15% respectively.

Conclusion: NFPAs in addition to their incidental discovery, are usually diagnosed lately as macroadenoma which commonly present with symptoms related to the mass effect on surrunding structures. They put at risk the vital and visual prognosis.