Complete evaluation of pituitary tumours in a single tertiary care institution
We retrospectively evaluated all patients with pituitary tumours treated in our department from 1/1/1997 to 01/11/2014.
Patients and methods
Two hundred and fifteen patients (124 females, 91 males, mean age 50.9 years) were treated because of pituitary tumours. All patients underwent basal hormonal analysis and when required dynamic testing in order to check for hormonal activity. Pituitary masses were divided into groups concerning their hormonal status and were further classified according to gender, age at diagnosis, tumour size, and the development of postoperative pituitary insufficiency when neurosurgical intervention was conducted.
One hundred and twenty-one patients had hormonally inactive tumours (non-functional adenomas; 56.3%), 57 prolactinomas (26.5%), 17 growth hormone secreting adenomas (7.9%), 16 Cushing’s disease (7.4%), and 4 craniopharyngiomas (1.9%). Tumours with maximum size <1 cm (microadenomas) were detected in 62 patients (28.8%) and ≥1 cm (macroadenomas) in 153 (71.2%) of all cases (rate 1:2.5). Ninty eight patients (45.6%) had surgery (87 transsphenoidal and 11 transcranial), of this group 34 with hormonally active tumours (37.8% of the 90 patients of this subcohort). Indications for surgery were an increased risk or manifestation of chiasma syndrome and clinical symptoms due to hormonal hypersecretion. Complete [32 cases (32.6%)] or partial [33 cases (33.7%)] postoperative insufficiency in minimum one pituitary axis was present in 65/98 (66.3%) of the operated patients.
Pituitary adenoma prevalence is rising due to widely available imaging procedures. The majority of the tumours in our cohort were macroadenomas and hormonally inactive. Tumour extirpation via the transsphenoidal or transcranial route resulted in functional pituitary impairment of variable extent in 2/3 of the patients.
KeywordsPituitary tumours Epidemiology Thuringia
Authors thank Department of Pathology, University of Jena, University Hospital Jena for its valuable help in assessing pituitary surgical specimens.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study and the Regional Ethical Committee approved the study.
- 1.S.L. Asa, Tumors of the Pituitary Gland (Armed Forces Institute of Pathology, Washington, DC, 1998)Google Scholar
- 15.R.J. Lloyd, K. Kovacs, W.F. Young Jr., W.E. Farrell, S.L. Asa, J. Trouillas, G. Kontogeorgos, T. Sano, B.W. Scheithauer, E. Horvath, R.E. Watson Jr., E.P. Lindell, A.L. Barkan, W. Saeger, V. Nose, R.Y. Osamura, S. Ezzat, S. Yamada, F. Roncaroli, M.B.S. Lopes, S. Vidal Ruibal, in Pathology and Genetics of Tumours of Endocrine Organs, ed. by R.A. DeLellis, R.V. Lloyd, P.U. Heitz (International Agency for Research and Cancer (IARC), Lyon, 2004), pp. 9–48Google Scholar
- 19.A. Tjörnstrand, K. Gunnarsson, M. Evert, E. Holmberg, O. Ragnarsson, T. Rosén, H. Filipsson Nyström, The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011. Eur. J. Endocrinol. 171, 519–526 (2014)Google Scholar
- 22.T.T. Agustsson, T. Baldvinsdottir, J.G. Jonasson, E. Olafsdottir, V. Steinthorsdottir, G. Sigurdsson, A.V. Thorsson, P.V. Carroll, M. Korbonits, R. Benediktsson, The epidemiology of pituitary adenomas in Iceland, 1955–2012: a nationwide population-based study. Eur. J. Endocrinol. 173, 655–664 (2015)Google Scholar
- 24.B. Ambrosi, G. Faglia, Multicenter Pituitary Study Group, in Pituitary Adenomas. New Trends in Basic and Clinical Research. Proceedings of the 5th European Workshop on Pituitary Adenomas, Venice, ed. by G. Faglia, P. Beck-Peccoz, B. Ambrosi, P. Travaglini, A. Spada (Excerpta Medica, Amsterdam, 1991), pp. 159–168Google Scholar
- 27.J.R. Davis, W.E. Farrell, R.N. Clayton, Pituitary tumours. Reproduction 121, 363–371 (2001)Google Scholar
- 28.B.W. Scheithauer, O. Kurtkaya-Yapicier, K.T. Kovacs, W.F. Young Jr., R.V. Lloyd, Pituitary carcinoma: a clinicopathological review. Neurosurgery 56, 1066–1074 (2005)Google Scholar
- 29.J. Trouillas, C. Girod, in Pituitary Adenomas, ed. by A.M. Landolt, M.L. Vance, P.L. Reilly (Churchill Livingstone, Edinburgh, 1996), pp. 27–46Google Scholar
- 31.M.M. Fernandez-Balsells, M.H. Murad, A. Barwise, J.F. Gallegos-Orozco, A. Paul, M.A. Lane, J.F. Lampropulos, I. Natividad, L. Perestelo-Pe ́rez, P.G. Ponce de Leo ́n-Lovato ́n et al.. Natural history of nonfunctioning pituitary adenomas and incidentalomas: a systematic review and metaanalysis. J. Clin. Endocrinol. Metab. 96, 905–912 (2011)CrossRefPubMedGoogle Scholar
- 32.G. Faglia, Epidemiology and pathogenesis of pituitary adenomas. Acta Endocrinol. 129(Suppl 1), 1–5 (1993)Google Scholar
- 33.W. Saeger, D.K. Lüdecke, M. Buchfelder, R. Fahlbusch, H.-J. Quabbe, S. Petersenn. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur. J. Endocrinol. 156, 203–216 (2007)Google Scholar
- 36.S. Varshney, C. Gupta, K.K. Bansal, S.S. Bist, S. Bhagat, Endoscopic trans-nasal trans-sphenoidal (TNTS) approach for pituitary adenomas: our experience. Indian J. Otolaryngol. Head Neck Surg. 65(Suppl 2), 308–313 (2013)Google Scholar