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JOURNAL OF NEUROSURGICAL SCIENCES

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Journal of Neurosurgical Sciences 2013 Settembre;57(3):267-75

lingua: Inglese

Clinical features and analysis in 1385 Chinese patients with pituitary adenomas

Shao S. 1, Li X. 2

1 Division of Endocrinology, Tongji Hospital, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, PR China;
2 Division of Infection control, The first People’s Hospital of Yichang, The People’s Hospital of China Three Gorges University, Yichang, PR China


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Aim: The prevalence of pituitary adenomas (PAs) is increasing as the development of imaging techniques. Few studies systematically documented the profile of these tumors in Chinese population. Our study is aimed to investigate the clinical features of PAs including the clinicopathologies, manifestations, and tumor recurrence.
Methods: A retrospective analysis of clinic records of patients (median age, 39 years) with PAs was performed. A total of 1385 patients diagnosed and treated surgically at Tongji hospital, Hubei Province, China during the years 1987 through 2009 were identified that met our inclusion criteria and formed the study group.
Results: The distribution of each PA subtype was nonfunctioning pituitary adenomas (NFPA) occupying 40.0% of the total subjects, pure prolactin-secreting (PRL+) adenomas 18.6%, mixed adenomas 14.4%, growth hormone-secreting (GH+) adenomas 6.0%, follicle-stimulating hormone/luteinizing hormone-secreting (FSH/LH+) adenomas 5.9%, adrenocorticotropic hormone-secreting (ACTH+) adenomas 4.6%, and thyroid-stimulating hormone-secreting (TSH+) adenomas 0.6%. The most common initial symptoms were visual disturbances (N.=664), endocrine disturbances (N.=645), and headaches (N.=532). Patients who complained of endocrine disturbances mostly presented menstrual dysfunction in females whereas acromegaly in males. A total of 45 cases developed to recurrence, most of which occurred within 3 years after surgery. PRL+ adenoma showed the lowest frequency of recurrence (0.8%).
Conclusion: Most adenomas were secretory PAs, with prolactinomas being the most common subtype. Visual defects, endocrine disorders, and headaches were the most common symptoms. Patients with PRL+ adenoma had the lowest chance to undertake recurrence. More clinical care and research activities are needed to improve the outcome of these patients.

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shaoshiying@hotmail.com