Endocrine Abstracts

There are clinical recommendations to conduct a hormonal investigation in all cases of pituitary tumors > 6 mm in size that seems to be uncertain.

The objective: To reveal features of pituitary macroadenomas with at least one size less than 10 mm

The materials and methods: We have analyzed medical records of 380 newly diagnosed patients with pituitary macroadenomas before any treatment: 162 non-functioning adenomas (NFAs), 74 prolactinomas, 144 somatotropinomas. Median patients’ age was 56 [47; 63] y.o., 30 [25; 44] y.o. and 48.5 [35; 58] y.o., accordingly.

The results: The prevalence of macroadenomas with one size less than 10 mm were: 8/162 (4.9%) NFAs, 10/74 (13.5%) prolactinomas and 14/144 (9.7%) somatotropinomas. All patients were female except 2 men with somatotropinoma. The first complaints of patients with NFAs were headache – 6/8, in prolactinomas were menstrual disorders – 8/10 and in somatotropinomas were headache – 6/14, appearance changes – 4/14. The “first referred” specialists were: NFAs – neurologist (6/8); prolactinomas – gynecologist (8/10), somatotropinomas – therapist (10/14). Age at diagnosis was: NFAs 39.5 [27.8; 60.5] y.o., prolactinomas 25 [19.5; 27.5] y.o., somatotropinomas 52 [21; 67] y.o. (P=0.009). Compared to the general group of patients with relevant hormonal activity, patients with NFAs and prolactinomas were younger, and patients with somatotropinomas were older. Pituitary tumour volumes were: NFAs 470.3 [191; 807] mm³, prolactinomas 384 [294; 564.4] mm³, somatotropinomas 594 [355; 756] mm³ (P>0.05). The pituitary macroadenomas were endosellar in 12/32 cases (4/8 NFAs, 5/10 prolactinomas and 3/14 somatotropinomas). Other different growth directions were suprasellar (3/8), laterosellar (3/10) and suprasellar (5/14), accordingly. Hypopituitarism (as secondary hypothyroidism) was diagnosed in 2/14 patients with somatotropinomas. Another 6 patients (4 – prolactinomas, 2 – somatotropinomas) had hypogonadism due to hyperprolactinemia.

The conclusions: Despite the small number of observations, we could describe some features of such pituitary “mini”-macroadenomas with one size less than 10 mm: mainly found in women; mainly found in prolactinomas and somatotropinomas; patients with NFAs and prolactinomas were younger and patients with somatotropinomas – older that general group of patients; in majority of cases had extrasellar extension. However, hypopituitarism was rare in such cases.