Exp Clin Endocrinol Diabetes 2015; 123 - P04_06
DOI: 10.1055/s-0035-1547664

Retrospective evaluation of pituitary tumours in a single tertiary care institution

D Askitis 1, C Kloos 2, W Battefeld 3, G Wolf 3, U Müller 4
  • 1Division of Endocrinology and Metabolic Diseases; Department for Internal Medicine III; University Hospital Jena
  • 2Fsu Jena; Klinik Fuer Innere Medizin III; Klinik Fuer Innere Medizin III
  • 3Division of Endocrinology and Metabolic Diseases; Department of Internal Medicine III; University Hospital Jena
  • 4Internal Medicine; Endocrinology and Metabolic Diseases; Division of Endocrinology and Metabolic Diseases

Introduction: We retrospectively evaluated all patients with pituitary tumours treated in our department from 1.1.1997 – 1.11.2014

Patients and methods: 215 patients (124 females: 91 males, mean age 50.9 y.) were treated because of pituitary tumours. All patients underwent basal hormonal analysis and 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.

Results: 121 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 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). 98 patients (45.6%) were operated (87 transsphenoidal and 11 transcranial), of this group 34/90 (37.8%) with hormonally active tumours. Indications for surgery were an increased risk or manifestation of chiasma syndrome and/clinical symptoms due to hormonal hypersecretion. Immunohistochemical stainings of the hormonally inactive tumours detected 18 gonadotrophic adenomas, 28 null-cell adenomas, 10 adenomas with other focal hormonal expression, 1 Rathke's cleft cyst, 2 cysts and 1 pituitary lesion because of hypophysitis. Complete (32 cases (32.6%)) or partial (33 cases (33.7%)) postoperative hypopituarism in minimum 1 pituitary axis was present in 65/98 (66.3%) of the operated patients.

Conclusions: 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 transphenoidal or transcranial adenectomy resulted in functional pituitary impairment in 2/3 of the patients.