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

Abstract

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.

The prevalence of acromegaly is higher than previously reported: Changes over a three‐decade period

“…Classic signs of acromegaly include the growth of hands, feet, and facial changes, together with less specific symptoms like joint and muscular pain, excessive sweating, snoring, and headache 5 . Before the 1990s the prevalence of acromegaly was reported to be 40–60/10 6 persons, 6–8 however, in more recent reports the prevalence has increased to 70–90/10 6 persons 1,9–14 . This increase has been ascribed to improved disease awareness and more incidental findings due to increased use of cerebral computed tomography (CT) and magnetic resonance imaging (MRI) scans 4,15 .…”

“… 5 Before the 1990s the prevalence of acromegaly was reported to be 40–60/10 6 persons, 6 , 7 , 8 however, in more recent reports the prevalence has increased to 70–90/10 6 persons. 1 , 9 , 10 , 11 , 12 , 13 , 14 This increase has been ascribed to improved disease awareness and more incidental findings due to increased use of cerebral computed tomography (CT) and magnetic resonance imaging (MRI) scans. 4 , 15 At the same time a shift towards a milder phenotype of acromegaly has been suggested.…”

Skull base reconstruction using in situ bone flap in patients with pituitary adenomas treated by endoscopic endonasal approach

“…Pituitary adenomas are the most common etiology of benign sellar masses, accounting for up to 10–15% of all diagnosed intracranial tumors, although there are other neoplastic, infectious, inflammatory, development, and vascular etiologies to be considered ( 20 – 22 ). Transsphenoidal surgery with an aim to achieve complete tumor resection is considered the first-line treatment for pituitary adenomas ( 23 ).…”

Atopy and allergic diseases among college students at a Saudi Public University

“…Studies are being conducted to see if lowering risk factors or using antiallergic medicines can change the long-term results in high-risk populations. [ 7 8 ]…”