Clinicopathologic Analysis of Pituitary Adenoma: A Single Institute Experience

Abstract

Pituitary adenoma (PA) is a common benign neuroendocrine tumor; however, the incidence and proportion of hormone-producing PAs in Korean patients remain unknown. Authors analyzed 506 surgically resected and pathologically proven pituitary lesions of the Seoul National University Hospital from 2006 to 2011. The lesions were categorized as: PAs (n = 422, 83.4%), Rathke's cleft cysts (RCCs) (n = 54, 10.6%), inflammatory lesions (n = 8, 1.6%), meningiomas (n = 4), craniopharyngiomas (n = 4), granular cell tumors (n = 1), metastatic renal cell carcinomas (n = 2), germinomas (n = 1), ependymomas (n = 1), and unsatisfactory specimens (n = 9, 1.8%). PAs were slightly more prevalent in women (M: F = 1:1.17) with a mean age of 48.8 yr (9-80 yr). Immunohistochemical analysis revealed that prolactin-producing PAs (16.6%) and growth hormone-producing adenomas (9.2%) were the most common functional PAs. Plurihormonal PAs and nonfunctioning (null cell) adenomas were found in 14.9% and 42.4% of patients with PAs, respectively. The recurrence rate of PAs was 11.1%, but nearly 0% for the remaining benign lesions such as RCCs. 25.4% of patients with PAs were treated by gamma-knife after surgery due to residual tumors or regrowth of residual tumor. In conclusion, the pituitary lesions and the proportions of hormone-producing PAs in Korean patients are similar to those of previous reports except nonfunctioning (null cell) PAs, which are unusually frequent.Graphical Abstract

Pituitary adenoma: a literature review

“…HA kli nið kai ga li pa si reikð ti dve jo pai: hor mo nø hi per produk ci jos ar hi pop ro duk ci jos su kel tais reið ki niais ir vie ti nio spau di mo reið ki niais (daþ niau siai neu ro lo gi niais) [13].…”

“…Tai daþ niau si kli ni ki niai sin dro mai. Go na dotro pi nø hi per pro duk ci ja ne su ke lia spe ci fi nio sin dro mo, o ti rot ro pi no mos, su ke lian èios hi per ti roi diz mà, yra re tos [10,13,43]. HA, tie sio giai spaus da mos liau kà, ga li su kel ti ir hor mo nø hi pop ro duk ci jos nu lem tà da li ná ar vi sið kà hipo pi tui ta riz mà.…”

“…Daþ niau sia ið ade no hi po fi zës ade no mø yra pro lak ti no ma (40-57 %), po jos se ka hor monø ne pro du kuo jan èios ade no mos (28-37 %), au gi mo hormo nà sek re tuo jan èios ade no mos (11-13 %), ad re no kor tikot ro pi ná hor mo nà (AKTH) sek re tuo jan èios ade no mos (1-3 %). Fo li ku lus sti mu liuo jan tá hor mo nà (FSH), liu teini zuo jan tá hor mo nà (LH) ir ti rot ro pi ná hor mo nà (TTH) sek re tuo jan èios ade no mos yra re tos [10,13]. HA ga li produ kuo ti dau giau nei vie nà hor mo nà ar hor mo nø hi per produk ci ja ga li kis ti dël hi po fi zës làs te liø plas tið ku mo.…”

Gonadotrophic pituitary incidentaloma as the cause premature ovarian insufficiency

“…Гендерные различия в частоте гипофизар-ных аденом характеризуются их преоблада-нием у женщин и увеличением встречаемости у мужчин старшего возраста [6][7][8][9].…”

“…Асимптомность инциденталом способствует их запоздалому выявлению, чаще уже в стадии макроаденом [8,9].…”