Non-Functioning Pituitary Adenomas: A Single Center Experience

Anagnostis, Panagiotis; Adamidou, Fotini; Polyzos, Stergios A.; Efstathiadou, Zoe; Panagiotou, Athanasios; Kita, Masahide

doi:10.1055/s-0030-1267991

Cited by 29 publications

(26 citation statements)

References 33 publications

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“…Indeed what we observed in our population is that only 11 % of microadenomas had HH and patients incidentally diagnosed most frequently had normal PGS (81 %, p = 0.003). Comparing with Anagnostis's series we had similar number of patients who were intervened (surgery 54 % in ours vs. 57 % and radiotherapy 6 % in ours vs. 9 %) [20]. Patients who had surgery seemed to be older (median 56 vs. 45.5 years).…”

Section: Nfpa Are Benign Intracranial Tumors With Potential Symptoms supporting

confidence: 66%

Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention

Monteiro

Freitas

Vieira

et al. 2017

Exp Clin Endocrinol Diabetes

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To determine the prevalence of hypogonadotropic hypogonadism (HH) among patients with non-functioning pituitary adenomas (NFPA) and the post-surgery outcome on pituitary gonadotropins secretion (PGS); to determine the prevalence of erectile dysfunction (ED) on male patients with NFPA, to evaluate the impact of testosterone replacement therapy (TRT) in those with HH. Retrospective evaluation of gonadal function in 109 NFPA patients (45 males), with a mean age of 51.8 years, diagnosed on the last 10 years. ED questionnaire applied to 34 male patients. Male patients with NFPA were significantly older (males 58.1±15.8 vs. females 47.4±16.94; p=0.001). Most patients had macroadenomas (67%; p=0.001) and only a minority were incidentalomas (19%; p<0.001). Prevalence of HH was 40% (60% on males, 25% on females; p<0.001). Surgery was performed in 54% of all patients (71% of males, 42% of females; p<0.003). After intervention, 14% became HH, 69% maintained previous function and 17% improved. On the questionnaire, 76% reported having ED, 54% of which had HH and 21% were under TRT. Of the patients under TRT, 79% still had ED. Median age of patients with ED was significantly higher [with ED 65 vs. without 49 years; p=0.012). There was no BMI difference between patients with or without TRT (28.0 vs. 27.4 Kg/m). NFPA was more frequent in older rather than younger patients. Males were older, had more HH and surgery. There was no significant improvement of pituitary function with surgery (17%) and 13% became iatrogenic HH. TRT had a low efficacy to improve ED in these patients.

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Section: Nfpa Are Benign Intracranial Tumors With Potential Symptoms supporting

confidence: 66%

Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention

Monteiro

Freitas

Vieira

et al. 2017

Exp Clin Endocrinol Diabetes

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“…In a prospective study of 63 patients with pituitary tumors, the prevalence of headache was 70%, and there was no correlation between tumor size and headache or between cavernous sinus invasion and headache . However, multiple studies on pituitary adenomas including microadenomas report headache as a frequent symptom that often significantly improves or resolves after surgery for the adenoma 25‐29…”

Section: Brain Tumor Headache In General and The Ichdmentioning

confidence: 99%

Headaches in Brain Tumor Patients: Primary or Secondary?

Nelson

Taylor

2014

Headache

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Our literature review revealed that brain tumor headache uncommonly presents with classic brain tumor headache characteristics and often satisfies criteria for a primary headache category such as migraine or tension-type. Thus, clinicians may miss headaches due to brain tumors in following ICHD-3 criteria, and the distinction between primary and secondary headache disorders may not be so clear-cut.

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“…NFPAs are difficult to recognize clinically until they are large enough to cause symptoms due to a mass effect (15,16). Almost 50% are detected as an incidental finding when MRI is done for other reasons (17)(18)(19). Hyperprolactinemia was found in 45.2% of a series of 66 macroadenomas with NFPA, with a mean value of 65.6 ng/mL (20).…”

Section: Discussionmentioning

confidence: 99%

Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature

Rosmino¹,

Tkatch²,

Paolo³

et al. 2020

Archives of Endocrinology and Metabolism

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The usual clinical presentation of non-functioning pituitary adenoma (NFPA) consists of symptoms of mass effect and hypopituitarism. NFPA is a rare condition in young women and an uncommon complication during pregnancy. We present the outcome of three patients with NFPA during pregnancy. Case 1: a 38-year-old woman was referred at 32 nd week of spontaneous pregnancy because of diagnosis of a pituitary macroadenoma discovered in the context of progressive visual loss. Hormonal deficiency and hypersecretion were ruled out. Prolactin levels were high as expected. She developed diplopia and severe headache despite the use of dopamine agonists and corticosteroids, so pregnancy was interrupted at 34 th week. After an uncomplicated delivery of a healthy newborn, transsphenoidal surgery was performed. The pathology was consistent with a gonadotroph adenoma. She recovered visual field, and remained with normal pituitary function. Postsurgical tumor remnant increased in size during the follow-up. Case 2: a 34-year-old woman was referred due to secondary amenorrhea and galactorrhea. A macroadenoma with suprasellar extension was discovered. Transsphenoidal surgery confirmed a gonadotroph adenoma. Two years after surgery she had a normal pregnancy. Six years after surgery a small tumor recurrence occurred. Case 3: a 23-year-old woman was referred due to a microincidental pituitary adenoma. Laboratory testing was normal. No findings on physical examination. A wait and see approach was decided. Two years after diagnosis, the patient got pregnant without complications. Image remained stable. This article may contribute new cases and provides an extensive review of NFPA during pregnancy.

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Non-Functioning Pituitary Adenomas: A Single Center Experience

Abstract: The majority of NFPAs not selected for surgery at diagnosis remained stable in size. Pituitary dysfunction and visual defects at diagnosis were common. Surgical debulking led to clinical improvement, but relapse occurred in 2/3 of the cases.

Cited by 29 publications

References 33 publications

Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention

Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention

Headaches in Brain Tumor Patients: Primary or Secondary?

Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature

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