Non-adenomatous sellar lesions: single-centre 10-year experience
| Autor: | José Cabral, Carlos Vasconcelos, Francisco Sousa Santos, Joana Graça, Sância Ramos, Clotilde Limbert, Conceicao Marques, João Costa, Joao Sequeira Duarte, Lídia Nunes Dias, Vanessa Henriques, Martinha Chorão |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Pituitary Diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Hypopituitarism Lesion Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Outpatient clinic Sella Turcica Child Aged Transsphenoidal surgery business.industry General Medicine Middle Aged medicine.disease Radiation therapy Single centre Outcome and Process Assessment Health Care Child Preschool Radiological weapon Female Radiology medicine.symptom Presentation (obstetrics) business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Hormones. 17:557-563 |
| ISSN: | 2520-8721 1109-3099 |
| DOI: | 10.1007/s42000-018-0064-y |
| Popis: | A minority of lesions found in the sellar region are non-adenomatous neoplastic, inflammatory, or cystic masses. Our study aims to describe the prevalence and characteristics of these lesions in a multidisciplinary pituitary outpatient clinic. We conducted an observational study which included 36 patients (15.9% of those followed up in this outpatient clinic between 2006 and 2016 who had pituitary surgery) submitted to pituitary surgery with histological results showing a non-adenomatous sellar lesion. We evaluated clinical, radiological, and biochemical (pituitary function) characteristics during the pre-operative and post-operative period. Thirty-six patients (50% female) with a mean age of 41.3 ± 21.9 years and a mean follow-up duration of 8.0 ± 9.0 years were included. Histologic diagnoses were divided into benign neoplasms (80.6%), malignant neoplasms (11.1%), inflammatory lesions (5.6%), and cystic masses (2.8%). The most common clinical presentation was headache (66.7%) and visual defects (61.1%). Forty-seven percent of patients had at least one pituitary axis insufficiency at the time of diagnosis. In the majority of cases (58.3%), a transsphenoidal approach was used for the initial pituitary surgery. Thirteen patients had more than one pituitary surgery and eight also had radiotherapy. At the time of data retrieval, five patients had no pituitary hormonal insufficiency and 13 patients had some visual defect improvement. Although rare, non-adenomatous sellar lesions may be associated with significant causes of morbidity, such as hypopituitarism and visual defects, per se or due to the various treatment modalities employed. Moreover, since the lesions are difficult to distinguish from adenomas, these patients require a careful multidisciplinary approach. |
| Databáze: | OpenAIRE |
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