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Secondary pituitary hormonal dysfunction patterns: tumor size and subtype matter.

Wael M Almistehi1, Nadine Vaninetti1, Syed Mustafa1

  • 1Division of Endocrinology and Metabolism, Dalhousie University, Halifax, NS, Canada.

Pituitary
|July 28, 2020
PubMed
Summary

Sellar masses (SM) often cause hormonal deficiencies. Nonfunctioning adenomas (NFA) are more likely to present with multiple deficiencies than prolactinomas (PRLoma), regardless of tumor size.

Keywords:
AdenomaHormonal deficiencyPituitarySecondarySellar mass

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Sellar masses (SM) are common pituitary tumors.
  • Secondary hormonal deficiency (SHD) is a frequent complication of SM at presentation.
  • The influence of SM pathology on SHD is not fully understood.

Purpose of the Study:

  • To investigate the relationship between sellar mass (SM) type and secondary hormonal deficiency (SHD) at initial presentation.
  • To determine if SHD is influenced by the specific pathology of the SM.
  • To analyze the impact of SM size and type on the likelihood of SHD.

Main Methods:

  • Retrospective analysis of 914 patients with SM.
  • Patients were enrolled in a provincial neuropituitary registry from 2005-2018.
  • SM were classified by size (<1 cm, 1-1.9 cm, 2-2.9 cm, >3 cm) and pathology.

Main Results:

  • SHD rates varied by SM type, highest in prolactinomas (PRLoma) and craniopharyngiomas, lowest in meningiomas.
  • Larger SM were more likely to present with SHD.
  • Nonfunctioning adenomas (NFA) had a significantly higher odds ratio (3.34) for multiple SHDs compared to PRLoma, independent of size, age, or gender.

Conclusions:

  • Sellar mass (SM) size and specific pathology significantly influence the rate and distribution of secondary hormonal deficiency (SHD).
  • Nonfunctioning adenomas (NFA) are particularly associated with multiple SHDs at presentation.
  • Findings aid clinicians in tailoring hormonal testing strategies for diverse SM pathologies.