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Sellar and perisellar meningiomas: effects on pituitary function in a Spanish cohort observational study
Fernando Guerrero-Pérez1,2, Betina Biagetti3,4, Miguel Paja-Fano5,6
1Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, Barcelona, Spain. ferguepe@hotmail.com.
Purpose:
Studies focused on the effects of sellar and/or perisellar (S/PS) meningiomas on pituitary function are scarce. The primary objective of the present study was to determinate the effects that S/PS meningiomas and their treatments have on pituitary function. Also, we described the clinical characteristics and therapeutic outcomes of the cohort of adult Spanish patients.
Methods:
A multicenter and retrospective study of patients with S/PS meningiomas attended in 20 tertiary Spanish centers.
Results:
165 patients, 123 (74.5%) females, with median age of 61.4 [51-71] years were analyzed. At presentation, 115 (69.7%) had visual disturbance, 62 (37.6%) headache, 46 (27.9%) cranial nerve palsy and 34 (26.2%) hypopituitarism. Median tumor diameter was 29.1 [22-35.5] mm and cavernous sinus infiltration was detected in 95 (59%). As initial treatment, 128 (77.6%) underwent surgery, 25 (15.2%) received radiotherapy and 12 (7.3%) were clinically and radiologically monitored. Among operated patients, gross total resection (GTR) was achieved in 44 (34.4%), whereas in 84 (65.6%) the tumor was incompletely removed. Overall median follow-up was 5.7 [2.9-9.2] years. After treatments, hypopituitarism was present in 86 (53.4%) patients at the last evaluation, and it was associated with surgery extension (subtotal or GTR) but not with tumor subtype, type of radiotherapy or radiation dose received.
Conclusions:
S/PS meningiomas affect the pituitary function in 25% of the cases. However, after the implementation of treatments, hypopituitarism prevails in more than 50% of the cases. They are relatively large tumors and GTR is achieved in one third of the cases in whom hypopituitarism is more prevalent.
Insights
Sellar and/or perisellar meningiomas frequently impact pituitary function, with over 50% of patients developing hypopituitarism after treatment. Gross total resection (GTR) is associated with a higher prevalence of hypopituitarism.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Sellar and/or perisellar (S/PS) meningiomas are tumors affecting the pituitary gland.
- Limited studies investigate the impact of S/PS meningiomas and their treatments on pituitary function.
Purpose of the Study:
- To determine the effects of S/PS meningiomas and their treatments on pituitary function.
- To describe clinical characteristics and therapeutic outcomes in adult Spanish patients with S/PS meningiomas.
Main Methods:
- A multicenter, retrospective study involving 165 adult patients from 20 Spanish tertiary centers.
- Analysis of clinical data, tumor characteristics, treatment modalities (surgery, radiotherapy, monitoring), and pituitary function outcomes.
Main Results:
- At presentation, 26.2% of patients had hypopituitarism. Post-treatment, hypopituitarism was present in 53.4% of patients.
- Surgery was the primary treatment (77.6%), with gross total resection (GTR) achieved in 34.4%.
- Hypopituitarism was associated with surgical extent (subtotal or GTR) but not tumor subtype, radiotherapy type, or dose.
Conclusions:
- S/PS meningiomas significantly affect pituitary function, with hypopituitarism prevalent in over 50% of cases post-treatment.
- These are relatively large tumors, and GTR is achieved in only one-third of cases, often correlating with higher rates of hypopituitarism.
