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International Journal of Clinical Case Reports 2014, Vol. 4, No. 5, 1-3
http://ijccr.biopublisher.ca
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Giant and Invasive Pituitary Adenomas in The Elderly
Said Azzoug , Farida Chentli
Endocrinological Department Bab El Oued Hospital Algiers Algeria
Corresponding author email:
saidazzoug@yahoo.fr
,
International Journal of Clinical Case Reports, 2014, Vol.4, No.5 doi: 10.5376/ijccr.2014.04.0005
Received: 12 Mar., 2014
Accepted: 28 Mar., 2014
Published: 24 Jul., 2014
© 2014 Azzoug and Chentli. This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Azzoug and Chentli, 2014, Giant and Invasive Pituitary Adenomas in The Elderly, International Journal of Clinical Case Reports, Vol.4, No.5, 1-3 (doi:
10.5376/ijccr.2014.04.0005)
Abstract
Clinical presentation of pituitary adenomas is influenced by age of patients and stage of the tumour at diagnosis. In this
study we intended to analyse the features of pituitary adenomas in old patients.
Subjects and Methods:
It is a retro- and prospective study concerning 37 patients aged 60 years and over harbouring a pituitary
adenoma. Patients with giant and/or invasive tumours which means tumours ≥ 40 mm or tumours invading the cavernous sinuses
(G1) were compared to patients with tumours < 40 mm without cavernous sinuses involvement (G2).
Results:
38% (N=14) of the tumours were giants and/or invasive, the adenoma size was 40.53 ± 11.38 mm in G1 (with involvement
of cavernous sinuses in 16%) and 22.7 ± 7.96 mm in G2, patients of G1 were older than those of G2: 70.71 ± 6.70 years vs 66.17
± 5.41 years. Neuro-ophthalmological manifestations were appealing in 78% in G1 and 61% in G2; the tumour was incidentally
discovered in 21% in G2 and 7% in G1. No secreting adenomas were the more prevalent in the two groups (64% in G1 and 61% in
G2); GH secreting adenomas were recorded only in G2. Pituitary deficiency wasn’t different between the two groups (61% in G1 vs
60% in G2). Severe visual loss was more prevalent in G1 than G2: 71% vs. 33%.
Conclusion:
Pituitary adenomas in the elderly are often large and invasive, predominantly no secreting and frequently diagnosed late
at an advanced stage of visual loss and pituitary deficiency.
Keywords
Pituitary adenoma; Giant adenoma; Invasive adenoma; Elderly
1 Introduction
Pituitary adenomas (PA) are deemed to be rare in old
patients; however, with increasing in life expectancy
and improvement in health care more pituitary
tumours will be diagnosed in old patients. Little is
known about PA in the elderly, what are the most
frequently presenting symptoms, what are their
phenotypes and what are their repercussions.
Furthermore, physiological changes and comorbidities
of old patients can delay the diagnosis and may
significantly influence clinical presentation and
outcome of these tumours. The aim of our study is to
analyze the features of giant and invasive adenomas in
patients aged 60 years and over.
2 Subjects and Methods
This is a retro- and prospective study concerning 37
patients (19F/18M) aged 60 years and over harbouring
a pituitary adenoma, these patients were divided into
two groups: Group 1 (G1) are patients with giant
and/or invasive tumours which means tumours ≥ 40
mm (Figure 1) or tumours invading the cavernous
sinuses (Figure 2).
Figure 1 Giant adenom
a
Group 2 (G2) are patients with tumours < 40 mm
without cavernous sinuses involvement. Presenting
symptoms were reviewed; all patients underwent a
thorough clinical examination, hormonal, radiological
and visual assessment.