Authors
1
Diagnostic Radiology, Al-Hindiyah Teaching Hospital /Karbala, Iraq.
2
Diagnostic Radiology, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq.
,
Document Type : Research Paper
Abstract
BACKGROUND:
Pituitary adenomas are tumors of the anterior pituitary. Most pituitary tumors are slow-growing and benign. They are classified based on size or cell of origin. Pituitary adenoma can be described as microadenoma, macroadenoma, and giant tumors based on size.
OBJECTIVE:
the present study aimed to assess the correlation between MRI findings and levels of prolactin and thyrotropin in addition to other characteristics of the patients.
PATIENTS AND METHODS:
An observational correlation study design conducted at Al-Yarmouk Teaching Hospital in the Department of Radiology from 1st of January 2021 through December 2021. The current study involved 101 patients as (22 males) and (79 females) (age ranging from 15- 60 years) as an outpatient with abnormal hormonal assay on lab investigations.
RESULTS:
Patients with microadenomas and macroadenomas were significantly older than those with normal findings, the mean age was 35.6±8.7 years, 40.6±11 years and 31.2±10.6 years, respectively, (P. value <0.05). Overall pituitary adenomas (micro and macro adenomas) were more frequent in females than males compared to normal findings, (P. value <0.05). Microadenomas were significantly more frequent than macroadenomas in obese (BMI=25-35 ) patients, 29.2% vs. (0%), respectively.
CONCLUSION:
Neuroimaging is an essancial method for evaluation of pituitary adenoma , Pituitary microadenomas more frequent in young adult , female patients with significant correlation to elevated prolactin levels. Macroadenomas more frequent in older , obese female patients.
- Molitch ME. Diagnosis and Treatment of Pituitary Adenomas: A Review. JAMA. 2017 ;317:516-24.
- Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, Vance ML., Endocrine Society. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96: 894-904.
- Agustsson TT, Baldvinsdottir T, Jonasson JG, Olafsdottir E, Steinthorsdottir V, Sigurdsson G, et al. The epidemiology of pituitary adenomas in Iceland, 1955-2012: a nationwide population-based study. Eur J Endocrinol. 2015;173:655-64.
- Evanson J. Radiology of the Pituitary. Endotext [Internet]. 2020 Jul 19. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279161/#radiologyPITUITARY_ADENOMAS. Accessed on: 13/9/2021.
- Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 2016 ;33:610–17.
- Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH. Pituitary adenomas: high-resolution MR imaging at 1.5 T. Radiology. 1990;161:761–65.
- Daly AF, Jaffrain-Rea M-L, Ciccarelli A, Valdes-Socin H, Rohmer V, Tamburrano G, et al. Clinical characterization of familial isolated pituitary adenomas. J Clin Endocrinol Metab. 2006;91:3316–23.
- Syro L V, Rotondo F, Ramirez A, Di Ieva A, Sav MA, Restrepo LM, et al. Progress in the diagnosis and classification of pituitary adenomas. Front Endocrinol (Lausanne). 2015;6:97.
- Cannavo S, Venturino M, Curto L, De Menis E, D’arrigo C, Tita P, et al. Clinical presentation and outcome of pituitary adenomas in teenagers. Clin Endocrinol (Oxf). 2003;58:519–27.
- Trouillas J, Roy P, Sturm N, Dantony E, Cortet-Rudelli C, Viennet G, et al. A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case–control study of 410 patients with 8 years post-operative follow-up. Acta Neuropathol. 2013;126:123–35.
- Chiloiro S, Doglietto F, Trapasso B, Iacovazzo D, Giampietro A, Di Nardo F, et al. Typical and atypical pituitary adenomas: a single-center analysis of outcome and prognosis. Neuroendocrinology. 2015;101:143–50.
- Daly AF, Beckers A. The epidemiology of pituitary adenomas. Endocrinol Metab Clin. 2020;49:347–55.
- Di Somma C, Scarano E, de Alteriis G, Barrea L, Riccio E, Arianna R, et al. Is there any gender difference in epidemiology, clinical presentation and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature. J Endocrinol Invest. 2021;44:957–68.
- Lake MG, Krook LS, Cruz S V. Pituitary adenomas: an overview. Am Fam Physician. 2013;88:319–27.
- Hwang Y-C, Chung JH, Min Y-K, Lee M-S, Lee M-K, Kim K-W. Comparisons between macroadenomas and microadenomas in Cushing’s disease: characteristics of hormone secretion and clinical outcomes. J Korean Med Sci. 2009;24:46–51.
- Bayrak A, Saadat P, Mor E, Chong L, Paulson RJ, Sokol RZ. Pituitary imaging is indicated for the evaluation of hyperprolactinemia. Fertil Steril. 2005;84:181–5.
- Wright K, Lee M, Escobar N, Pacione D, Young M, Fatterpekar G, et al. Tumor volume improves preoperative differentiation of prolactinomas and nonfunctioning pituitary adenomas. Endocrine. 2021;74:138–45.
- Zielinski G, Ozdarski M, Maksymowicz M, Szamotulska K, Witek P. Prolactinomas: Prognostic Factors of Early Remission After Transsphenoidal Surgery. Front Endocrinol (Lausanne). 2020;11:1–7.
- Tjörnstrand A, Nyström HF. Diagnostic approach to TSH-producing pituitary adenoma. Eur J Endocrinol. 2017;177:R183–97.
- Takamizawa T, Horiguchi K, Nakajima Y, Okamura T, Ishida E, Matsumoto S, et al. Central Hypothyroidism Related to Pituitary Adenomas: Low Incidence of Central Hypothyroidism in Patients with Acromegaly. J Clin Endocrinol Metab. 2019;104:4879–88.
- Yamada S, Fukuhara N, Horiguchi K, Yamaguchi-Okada M, Nishioka H, Takeshita A, et al. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg. 2014;121:1462–73.