Valor pronóstico de las características clínicas, bioquímicas e imagenológicas en los pacientes con macroadenomas hipofisarios clínicamente no funcionantes al momento del diagnóstico

Background and objective: Clinically non-functioning pituitary macroadenomas (NFPA) are the most common, and yet the least studied pituitary neoplasm. This study analyzes the baseline characteristics of a large group of patients with NFPA in an attempt to identify those features that may have a prognostic value. Material and methods: A database with the demographic, clinical, biochemical, imagenological and therapeutic characteristics of 312 patients with NFPA that attended the neuroendocrine clinic from March 2008 to June 2009 was created and analyzed. Results: The database included 173 men (55.4%) and 139 women (44.6%), with a mean age of 53.4 ± 13.7 years. The most common clinical presentations were: bitemporal hemianopsia (86.5%), headache (66%), pituitary apoplexy (6.7%) and oculo-motor palsies (6.1%); in 6.1% the finding was incidental. 48.4, 38.8 and 28.8% of the patients, had central hypothyroidism, hypogonadism and hypocortisolism, respectively; 20.2% had two or more hormonal deficiencies. Mean tumor volume was 14,248 ± 1,115 mm3. Pituitary surgery was the primary treatment in all cases; only 53 subjects were referred for radiotherapy. The recurrence rate after the first surgery was 33% after a mean follow up of 44 ± 39.25 months. Conclusion: None of the analyzed characteristics seemed to predict clinical/biological behavior of these tumors.