ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)
Incidental pituitary macroadenoma: natural history and surgical results
Stefan Matei Constantinescu 1 , Orsalia Alexopoulou 1 , Thierry Duprez 2 , Raluca Furnica 1 , Edward Fomekong 3 , Christian Raftopoulos 3 & Dominique Maiter 1
1Cliniques universitaires Saint-Luc (UCLouvain), Department of Endocrinology and Nutrition, Bruxelles, Belgium; 2Cliniques universitaires Saint-Luc (UCLouvain), Department of Radiology, Bruxelles, Belgium; 3Cliniques universitaires Saint-Luc (UCLouvain), Department of Neurosurgery, Bruxelles, Belgium
Introduction: The Incidental diagnosis of non-functioning pituitary macroadenomas (NPFMA) is becoming more prevalent with the spread of modern imaging techniques. More clinical data about their natural history and surgical results are needed.
Methods: We retrospectively analyzed medical files of patients referred to our clinic for an incidental NFPMA between 2010 and 2019. In particular, we compared patients that experienced tumor growth or not during surveillance, and surgical results in patients who had deficits or not at surgery.
Results: We included 65 patients (mean age ± SD: 60 ± 14 years; mean maximal diameter: 20.0 ± 7.3 mm). 44% had pituitary hormone deficits (LH/FSH 41%, TSH 29%, ACTH 15%) and 12% had visual field deficits. 26 patients had early surgery and 13 had delayed surgery after initial surveillance. In the surveillance group (n=35), the risk of tumor growth was estimated at 10%/year (median time of 57 months to reach 50%). Patients with hormonal deficit at diagnosis tended to experience earlier growth (P=0.082). Overall surgery led to stable or improved endocrine function in 91% (31/34) of patients, with only 6% (2/34) post-operative permanent diabetes insipidus. Surgery was more effective in preserving intact endocrine function (10/12) than restoring altered endocrine function to normal (6/22, P=0.03),
Conclusion: Incidental NFPMA are often responsible for unrecognized endocrine and visual deficits and require careful evaluation. If surveillance is chosen, the risk of growth is significant (10%/year) and seems to occur faster in patients already harboring an endocrine deficit. Early surgical removal before endocrine deficits occur might lead to better endocrine outcome.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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