ECE2022 Poster Presentations Pituitary and Neuroendocrinology (127 abstracts)
Differences in pituitary apoplexy
Betina Biagetti 1 , Silvana Isabel Sarria Estrada 2 , Cordero-Asanza Esteban 3 , Anas Chaachou-Charradi 4 , Karelis Ng-Won 2 , Marta Cicuendez Lopez Ocana 3 , Irene Hernández-Hernández 1 , Alba Rojano Toimil 1 , M Pilar Costa Forner 1 , Martinez-Saez Elena 4 , Anna Casteras 1 & Rafael Simo Canonge 1
1Hospital Vall d’Hebron, Endocrinology, Barcelona, Spain; 2Hospital Vall d’Hebron, Neuroradiology Section, Radiology Department, Barcelona, Spain; 3Hospital Vall d’Hebron, Neurosurgery and Neurotraumatology, Barcelona,; 4Hospital Vall d’Hebron, Pathology Department, Barcelona, Spain
Objective: Pituitary apoplexy (PA) is a rare, sometimes life-threatening clinical syndrome. However, some cases are subclinical (SPA), just revealed by MR performed during the follow-up of known pituitary adenomas or due to other conditions. Our aims were to describe the clinical characteristics and evolution of the patients with SPA compared with patients with acute PA (APA). We also compare the results of surgery vs conservative management in the APA group.
Design: Retrospective longitudinal study.
Methods: We retrospectively analysed a database of a tertiary reference centre searching for patients diagnosed with pituitary apoplexy between January 2010 and August 2021. We analysed the risk factors that differentiate SPA to APA and compared the clinical course between patients who received conservative vs surgical treatment. Statistical analysis was done using Fisher’s exact, Mann–Whitney test or Kruskal-Wallis with Bonferroni correction if required.
Results: Thirty-seven patients were identified (17 men, 20 women; age range 18.3–80.8 years, median age 47.7 years). Out of 37 patients, 29 (78.4%) had APA [of which 17 underwent surgery and 12 were conservatively managed] and 8 (21.6%) had SPA. T2DM (11 vs 0; P< 0.05), dyslipidemia (10 vs 0P=0.05) and bigger tumours (5589 ± 8562 mm vs 650 ± 879 mm; P<0.05) with chiasmatic compression and sinus invasion were more frequent in APA vs SPA and in patients requiring surgery. During follow-up (23.0 ± 42.0 months), 13/37 (35.1%) patients developed hypopituitarism without differences between groups. Pituitary adenomas’ volumes shrunk spontaneously in 13/20 (65%) of non-surgical patients with a median of volume reduction at 1 year MRI of (40.0% vs 23.7%) in conservatively APA vs SPA group respectively. 2 patients had a new apoplexy episode and 4 patients died, 1 related to PA.
Conclusions: These data suggest that bigger tumours in T2DM patients have higher risk of APA and could require surgery. In non-surgical group, the pituitary tumor shrinkage is clinically relevant after one year of PA. Hypopituitarism is quite frequent independently of PA type even in patients with SPA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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