Endocrine Abstracts

Background and Aim: Non-functioning pituitary adenoma (NFPA) is the second most common subtype of pituitary adenomas. This study aims to detail the clinical and biological particularities of NFPA in the Tunisian population.

Patients and Methods: A retrospective descriptive study of 35 patients followed for NFPA was conducted between 2000 and 2022 at the endocrinology Department of Hedi Chaker University Hospital, Sfax, Tunisia.

Results: The mean age was 52.1 ± 11.4 years with a male predominance (61.3%). The diagnosis of NFPA was motivated by tumoural syndrome in 77.4% of cases or by signs of hypopituitarism in 9.7% of cases. In 12.9%, it was an incidental discovery of a pituitary incidentaloma. The majority of NFPA were macroadenomas (90%). The initial clinical presentation was dominated by headache (90.3%) and visual impairment (80.6%). Visual field loss was observed in 30% of patients; 26.7% of them had bilateral visual field loss. In 3.2% of patients, NFPA caused bilateral blindness. The patients suffered from signs of pituitary insufficiency which could affect one or more axes: the corticotropic axis was the most affected (67.7%), followed by the thyroid (41.9%) and gonadotropic (41.9%) axes. Only 6.5% had somatotropic or lactrotropic insufficiency at the time of the biological evaluation. Disconnection hyperprolactinemia was observed in 26.7% with values exceeding 60 ng/ml in only 10% of cases.

Discussion: The diagnosis of NFPA is often delayed due to a long insidious evolution, especially in males. It is generally revealed by signs of tumor compression, sometimes severe, such as visual impairment, or by signs of anterior pituitary insufficiency. Surgery is the standard treatment. The earlier the diagnosis is made, the more complete the surgical resection will be.

References: 1. Chanson, Philippe, et al. "Management of clinically non-functioning pituitary adenoma." Annales d’endocrinologie. Vol. 76. No. 3. Elsevier Masson, 2015. 2. Ntali, Georgia, and John A. Wass. "Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas." Pituitary 21.2 (2018): 111-118.