Alberto Stefano Tresoldi1,2, Giulia Carosi1,3, Nazarena Betella1,2, Giulia Del Sindaco2,3, Rita Indirli2,3, Emanuele Ferrante3, Elisa Sala2,3, Claudia Giavoli3, Emanuela Morenghi4, Marco Locatelli5,6, Davide Milani7, Gherardo Mazziotti1,8, Anna Spada2, Maura Arosio2,3, Giovanna Mantovani9,10, Andrea Gerardo Antonio Lania1,8. 1. Endocrinology, Diabetology and Medical Andrology Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy. 2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 3. Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Biostatistics Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy. 5. Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. 7. Neurosurgery Unit, Humanitas Clinical and Research Hospital, Rozzano, Italy. 8. Department of Biomedical Sciences, Humanitas University, Rozzano, Italy. 9. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy, giovanna.mantovani@unimi.it. 10. Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, giovanna.mantovani@unimi.it.
Abstract
INTRODUCTION: Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs). OBJECTIVE: To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs. METHODS: Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers. RESULTS: Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p < 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas; p < 0.001) and age (higher in older patients; p < 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomas p = 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis). CONCLUSIONS: Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.
INTRODUCTION: Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs). OBJECTIVE: To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs. METHODS: Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers. RESULTS: Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p < 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas; p < 0.001) and age (higher in older patients; p < 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomas p = 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis). CONCLUSIONS: Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.
Authors: E Biamonte; N Betella; D Milani; G B Lasio; S Ariano; S Radice; E Lavezzi; G Mazziotti; A Lania Journal: Endocrine Date: 2020-11-26 Impact factor: 3.633
Authors: Renato Cozzi; Maria Rosaria Ambrosio; Roberto Attanasio; Claudia Battista; Alessandro Bozzao; Marco Caputo; Enrica Ciccarelli; Laura De Marinis; Ernesto De Menis; Marco Faustini Fustini; Franco Grimaldi; Andrea Lania; Giovanni Lasio; Francesco Logoluso; Marco Losa; Pietro Maffei; Davide Milani; Maurizio Poggi; Michele Zini; Laurence Katznelson; Anton Luger; Catalina Poiana Journal: Eur J Endocrinol Date: 2022-02-03 Impact factor: 6.664