Endocrine Abstracts

Objective: To study the spectrum of Pituitary tumours, their presentation, treatment and compliance with follow-up.

Methods: A mixed retrospective and prospective study was conducted at the Medicell Institute of Diabetes, Endocrinology and Metabolism (MIDEM) and Jinnah Postgraduate Medical Centre (JPMC) Karachi, Pakistan. All cases of pituitary tumours, were prospectively followed. Data regarding age, gender, duration of disease, symptoms, mode of treatment administered and compliance with the follow-up instructions was retrieved.

Results: A total of 173 patients were enrolled with a mean age of 36.4±10.6 years. Female predominance was seen in our study 97 (56.1%). Of the 136 married patients, subfertility was seen in 48 (36.3%). Headache was observed in 164 (94.8%) of patients. Prolactinoma was the lead tumour comprising of 76 cases (43.9%), followed by non-secretory tumours 47 (27.2%), and acromegaly 43 (24.9%). Other rare disorders including Cushing’s disease, craniopharyngioma and gonadotropinoma were also seen. Cabergoline was prescribed in 136 (78.6%) cases. Transsphenoidal surgery (TSS) was done in 74 (42.8%) of patients. Out of 97 female patients, 38 (39.2%) had persistent amenorrhea post-treatment, while this data was not available for 40 (41.2%) of these women, who were lost to follow-up. The difference between mean prolactin levels prior and after the treatment (1390.048±2646.986 versus 116.360±163.369) were found to be statistically significant P<0.001). Similarly, IGF-1 levels were significantly improved post treatment indicating tumour stability. Moreover, the level of mean FT4 post-treatment was 1.64, reflecting adequate replacement.

Conclusion: Majority of the patients had improvement post-treatment in pituitary tumour symptoms, including vision, headache and sexual function. Failure to attend for follow-up for tumour stability, control of excess hormone, and pituitary hormone replacement was seen in a large number of patients in this study. This requires careful consideration of different strategies to ensure better long term care in pituitary tumours.