Clinical, Radiological and Hormonal Characteristics of Our Patients with Primary Empty Sella: A Single-Centre...

A common incidental radiological finding in asymptomatic adults is primary empty sella (PES). We examined the clinical, radiological and hormonal features of patients with PES to identify risk factors and guide follow-up strategies.

The study included 120 patients with PES. Data on patients was obtained retrospectively and included details on symptoms, diseases, as well as radiological, biochemical and hormonal findings. Patients were divided into two groups (partial and total) according to sella turcica cerebrospinal fluid volume and pituitary height. They were also classified as having isolated hormone deficiency (HD), hypopituitarism or panhypopituitarism according to the severity of pituitary insufficiency.

HD was found in 83.3% of the study group. The most common causes were growth hormone deficiency and central hypogonadism. The two groups were indistinguishable with regard to pituitary insufficiency; however, panhypopituitarism was more prevalent in the total PES group (60.5% vs 30.5%). PES was more common in women, while both general and severe HD were more common in men. Pituitary height was positively correlated with thyroid stimulating hormone, free T4, insulin-like growth factor-1, testosterone, estradiol, adrenocorticotropic hormone and cortisol (r=0.275, p=0.002; r=0.277, p=0.002; r=0.394, p<0.001; r=0.319, p<0.001; r=0.195, p=0.032; r=0.220, p=0.016; r=0.310, p=0.001). Low pituitary height and male gender were associated with an increased risk of panhypopituitarism (p=0.002 vs p=0.015).

Pituitary insufficiency is common in PES, but panhypopituitarism is more common in total PES. Low pituitary height and male gender are risk factors for panhypopituitarism. Patients with these characteristics should be monitored more closely.