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Incidental pituitary macroadenoma: a population-based study

G M Nammour1, J Ybarra, M H Naheedy

  • 1Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

The American Journal of the Medical Sciences
|November 20, 1997
PubMed
Summary
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The prevalence of incidental pituitary macroadenoma in living patients is 0.20%. Early screening is crucial for detecting hormonal deficiencies and visual field defects in these patients.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Radiology

Background:

  • Epidemiologic data on incidental pituitary macroadenoma are scarce, primarily from autopsy studies.
  • No prior studies have established the prevalence in living patient populations.

Purpose of the Study:

  • To determine the prevalence of incidentally discovered pituitary macroadenoma in a living patient cohort.
  • To assess the clinical significance of these incidental findings.

Main Methods:

  • Observational study analyzing cranial computed tomography (CT) reports from 3,550 patients.
  • Review of CT films and medical charts for confirmed cases of pituitary macroadenoma.
  • Exclusion of patients with pre-existing pituitary or parasellar disease.

Related Experiment Videos

Main Results:

  • Seven cases of incidental pituitary macroadenoma (1-2.5 cm) were identified, yielding a prevalence of 0.20%.
  • Most patients exhibited partial hypopituitarism.
  • While initial visual fields were normal, Goldmann perimetry revealed defects in one-fourth of patients.

Conclusions:

  • Incidental pituitary macroadenoma has a low prevalence (0.20%) but requires vigilant screening.
  • Screening is essential for early detection of hormonal deficiencies (corticotropin, TSH, gonadotropins) and visual field impairments.