Pituitary incidentalomas: a single-centre experience

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

doi:10.1111/j.1742-1241.2010.02537.x

Cited by 33 publications

(24 citation statements)

References 30 publications

(86 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies on incidentally discovered NFPA reported a male preponderance ranging from 52 to 75% (3,8,10). Our data confirm a gender imbalance.…”

Section: Discussionsupporting

confidence: 81%

“…However, more patients are diagnosed because of an imaging study performed for unrelated reasons, the so-called pituitary incidentaloma. The definition of pituitary incidentaloma varies among authors: some include only lesions that satisfy radiographic criteria for pituitary adenoma (3,4), whereas others include all sellar lesion (5,6,7,8,9,10). Pooling the data of 18 902 subjects in a meta-analysis, Molitch (11) reported that the frequency of pituitary adenomas found at autopsy in subjects with no ante-mortem history of pituitary diseases was 10.7% (range, 1.5-31%), but almost all tumors were tiny microadenomas.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients' characteristics

Losa

Donofrio

Barzaghi

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Few data are available on the surgical results in patients with incidentally discovered nonfunctioning pituitary adenoma (NFPA). We investigated the efficacy and safety of surgery in patients with incidentally discovered NFPA. Design: Retrospective analysis of prospectively recorded outcomes. Methods: From 1990 to 2011, of 804 consecutive patients undergoing surgery for NFPA, 212 cases had an incidentally discovered tumor (26.4%). Among them, 117 patients were asymptomatic, while 95 had some visual and/or hormonal deficit. The main outcome of the study was to evaluate the frequency of radical resection as judged on the first postoperative neuroimaging study and detection of recurring disease during long-term follow-up. Results: Postoperative residual tumor was detected in 8.9% of patients with asymptomatic incidentalomas as compared with 31.2% of patients with symptomatic incidentalomas (P!0.001) and 41.2% of patients in the control group (P!0.001). Multivariate analysis confirmed that having an asymptomatic incidentaloma was independently associated with a better outcome. The 5-year recurrence-free survival in patients with incidentaloma was 86.8% (95% CI 80.2-92.4%) as compared with 77.9% (95% CI 73.6-82.2%; P!0.01) in the control group. This difference was almost completely due to a lower frequency of relapse in asymptomatic patients. Multivariate analysis confirmed the independent lower risk of tumor recurrence in asymptomatic NFPA. Conclusion: Our study shows for the first time that surgically treated patients with asymptomatic NFPA have a better early and long-term outcome that is independent from all the other demographic, clinical, and morphologic characteristics of the patients.

show abstract

“…Previous studies on incidentally discovered NFPA reported a male preponderance ranging from 52 to 75% (3,8,10). Our data confirm a gender imbalance.…”

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients' characteristics

Losa

Donofrio

Barzaghi

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…1 Based on combined data of micros and macros (weighted heavily towards macros), when hypopituitarism does occur, GH and gonadotrophin deficiency are the most likely to be present, followed by ACTH and TSH deficiency. [3][4][5][6] We have noted that among our patients with micros, those with ACTH-secreting adenomas seem to have a higher prevalence of central hypothyroidism (HT) compared to other micro types (both hormone-secreting and clinically nonfunctioning) of comparable size. We speculated that this might be related to the effects of hypercortisolism on the hypothalamic-pituitary-thyroid axis.…”

Section: Introductionmentioning

confidence: 90%

“…As larger micros may resemble macros in their ability to compromise anterior pituitary function, recent Endocrine Society guidelines recommend testing for hypopituitarism in all patients with an incidentally discovered pituitary adenoma, regardless of size . Based on combined data of micros and macros (weighted heavily towards macros), when hypopituitarism does occur, GH and gonadotrophin deficiency are the most likely to be present, followed by ACTH and TSH deficiency …”

Section: Introductionmentioning

confidence: 99%

ACTH‐secreting pituitary microadenomas are associated with a higher prevalence of central hypothyroidism compared to other microadenoma types

Mathioudakis

Thapa

Wand

et al. 2012

Clinical Endocrinology

View full text Add to dashboard Cite

Summary Context Unlike pituitary macroadenomas, microadenomas (micros) are not commonly associated with hypopituitarism. In clinical practice, we have observed that patients with ACTH-secreting micros have a higher than expected prevalence of central hypothyroidism (HT), and we speculated that this effect might be because of glucocorticoid-induced suppression of the hypothalamic–pituitary–thyroid axis. Objective To determine whether there is a difference in the prevalence of central HT among ACTH micros compared to other types of microadenoma, and if so, to investigate whether this is directly related to the degree of hypercortisolism. Design, setting and patients Retrospective study of 149 newly diagnosed patients with pituitary micros: 34 ACTH-secreting, 72 prolactin-secreting (PRLomas) and 43 clinically nonfunctioning adenomas (NFAs). Main outcomes measures Prevalence of central HT, correlation between normalized free T4 or TSH vs normalized urinary free cortisol (UFC) or salivary cortisol. Results The prevalence of central HT was significantly higher in the ACTH compared to the non-ACTH adenomas: 18% (ACTH), 1% (PRL) and 0% (NFAs). The mean normalized free T4 was lower in the ACTH micros compared to the non-ACTH micros (1·29 ± 0·06 vs 1·50 ± 0·23, P = 0·0001). There was no correlation between the degree of hypercortisolism, as reflected by 24-h urine free cortisol and salivary cortisol, and free T4 or TSH levels among the ACTH adenomas. Similarly, there were no differences in mean UFC or salivary cortisol between ACTH adenomas with and without central HT. Following transsphenoidal adenomectomy, central HT recovered in three of six patients with ACTH micros. Conclusions These findings suggest that patients with ACTH-secreting microadenomas should always, at a minimum, undergo testing for central HT. However, given the potential for recovery of thyroid function following cure of Cushing disease, we recommend withholding thyroid hormone replacement until after pituitary surgery.

show abstract

“…Also, the majority of the patients had macroadenomas at diagnosis, which is in line with other studies. 19,20 Interestingly, however, the rate of vision loss was much lower in the pituitary incidentalomas cohort compared to CMSMs (2.9 vs 24.1%, P<.01). This could be due to the difference in the actual size of macroadenomas between the two groups.…”

Section: Discussionmentioning

confidence: 87%

Prevalence and characteristics of sellar masses in the city of Al Ain, United Arab Emirates: 2011 to 2016

et al. 2020

View full text Add to dashboard Cite

BACKGROUND: The prevalence of sellar masses (SMs) is reported in Europe and North America but only limited data are available from the Middle East and North Africa (MENA) region. OBJECTIVES: Assess the prevalence and characteristics of SMs in Al Ain city, United Arab Emirates. DESIGN: Retrospective, descriptive multicenter study. SETTING: Three endocrine centers in Al Ain. PATIENTS AND METHODS: All patients diagnosed with SMs in the city of Al Ain, Emirate of Abu Dhabi, between 2011 and 2016 were evaluated. Cases were identified using ICD 9 and 10 codes and demographic and clinical data were collected. The prevalence rate was calculated for patients alive and residing in Al Ain city until 31 December 2016. MAIN OUTCOME MEASURES: Clinical presentations and prevalence rate. SAMPLE SIZE: 272. RESULTS: The mean (SD) age on presentation was 40.8 (14.3) years (range: 6-114 years, median: 40.0). The 170 (61.8%) females and 128 (46.5%) were native citizens of the United Arab Emirates. Two hundred and forty five (90%) patients had pituitary adenomas (PAs) while 27 (10%) had non-pituitary sellar lesions. The four most common SMs were prolactinoma (n=139, 51.1%), nonfunctioning adenoma (NFA) (n= 69, 25.4%), somatotroph adenoma (n=32, 11.8%) and craniopharyngioma (n=15, 5.5%). Patients with prolactinoma, corticotroph adenoma, and Rathke's cleft cyst had small sellar masses (<1 centimeter) while the majority of patients with other SMs had macroadenomas. Hypogonadism and growth hormone deficiency was present in 41.8% and 20.5% of the patients, respectively. Of 268 patients with available data, 82 patients underwent surgery while 25 patients received radiotherapy. At the end of 2016, 197 patients were residing in Al Ain city. The overall prevalence of SMs was 25.7/100 000 with PAs constituting most of these masses (n=177) for a prevalence of 23.1/100 000. CONCLUSIONS: This is the first study of SMs in the United Arab Emirates and the MENA region. Prolactinoma and NFA were the two most common SMs. Further studies are needed to explore the reasons for the lower prevalence of SMs in our region compared with other countries. LIMITATIONS: Retrospective design, relatively small sample size. CONFLICT OF INTEREST: None.

show abstract

Pituitary incidentalomas: a single-centre experience

Abstract: Majority of PIs are non-functioning adenomas that remain stable in size. Relapse in size and hypopituitarism postoperatively are common. PIs, for which conservative management was initially considered appropriate, did not progress in size.

Cited by 33 publications

References 30 publications

Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients' characteristics

Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients' characteristics

ACTH‐secreting pituitary microadenomas are associated with a higher prevalence of central hypothyroidism compared to other microadenoma types

Prevalence and characteristics of sellar masses in the city of Al Ain, United Arab Emirates: 2011 to 2016

Contact Info

Product

Resources

About