Giant and Invasive Pituitary Adenomas in the Elderly  

Said Azzoug , Farida Chentli
Endocrinological department Bab El Oued Hospital Algiers Algeria
Author    Correspondence author
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
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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
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