[Pituitary adenomas in elderly patients]

Area of Science:

• Neuroendocrinology
• Neurosurgery
• Geriatric Medicine

Background:

• Pituitary adenomas are common brain tumors, particularly in older adults.
• Management strategies for pituitary adenomas in the elderly require careful consideration due to potential comorbidities and altered physiological responses.

Purpose of the Study:

• To evaluate the clinical presentation, treatment outcomes, and long-term follow-up of pituitary adenomas in patients over 65 years old.
• To assess the safety and efficacy of different treatment modalities, including surgery and medical management.
• To determine causes of mortality in this patient cohort.

Main Methods:

• Retrospective and cross-sectional study of 37 patients aged over 65 with pituitary adenoma.
• Analysis of clinical data, tumor characteristics, treatment interventions, and follow-up outcomes.
• Evaluation of surgical complications, visual field improvements, and tumor progression.

Main Results:

• Non-functioning adenomas were most prevalent (76%). Visual field defects (56%) and neurological symptoms (57%) were common.
• Trans-sphenoidal surgery showed a 54% visual field improvement with 23% complications; trans-cranial surgery had 33% improvement with 50% complications.
• No tumor progression was observed in non-functioning adenomas with normal visual fields under watchful management.

Conclusions:

• Elderly patients with non-functioning pituitary adenomas and normal visual fields may be managed with a watchful approach and periodic monitoring.
• Trans-sphenoidal surgery is a safe and effective option for pituitary adenomas causing visual field defects in the elderly.
• Medical treatment is appropriate for secreting adenomas, considering patient comorbidities.