title: Retrospective multicentric study of pituitary incidentalomas.
abstract: Previously unsuspected pituitary tumors (incidentalomas) were analyzed in autopsies (4.8-27%) and magnetic resonance imaging (MRI) (10-37%), most of them being micro-pituitary incidentalomas (PI). However, patients with PIs sometimes had macroadenomas which may relate to previously unsuspected neurological and/or endocrine abnormalities. This study aims to establish the incidence of macro- vs. micro-PIs, the need for medical and/or surgical treatment and the neurological and endocrine dysfunction in a retrospective evaluation of patients with PIs studied over six years (1994-2000). Thirty-eight of 46 patients with PIs (22 males), aged 16-77, were followed for a mean of 3.2 years. Initial hormonal testing, ophthalmologic evaluation and MRI were repeated during follow-up. Twenty-nine (63%) of 46 patients had macro-PIs and 17 (17%) micro-PIs. Twenty-three males (75%) had macro-PIs, 10 (34.5%) with visual field defects. Consultations leading to PI diagnosis were chronic headache (28%), cranial trauma (15.3%), sinusitis (13%) and stroke (13%). Partial deficiencies of the anterior pituitary function were confirmed in 19 PIs (41.3%), with secondary hypogonadism prevailing (30%). Seven PIs (15%) were prolactinomas treated with dopamine agonists. Seventeen PIs (37%) underwent surgery. Immunohistochemical analysis showed gonadotrophinomas (30%), plurihormonal non-secreting adenomas (40%), and pituitary adenomas not reacting to any of the anterior pituitary hormone antibodies (30%). One operated macro-PI was a craniopharyngioma. Our data show a high percentage of PIs are macro-incidentalomas against expectations from necropsy and imaging studies. Most macro-PIs are found in males and are clinically non-functioning adenomas, 37% requiring surgery and hormonal substitution.
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina. patricia.fainstein@hospitalitaliano.org.ar.|, Lezica 3954, 1202, Buenos Aires, Argentina. patricia.fainstein@hospitalitaliano.org.ar.
authors.forename: Patricia Fainstein
authors.initials: PF
authors.lastname: Day
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Mirtha
authors.initials: M
authors.lastname: Guitelman
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Rosa
authors.initials: R
authors.lastname: Artese
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: León
authors.initials: L
authors.lastname: Fiszledjer
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Alberto
authors.initials: A
authors.lastname: Chervin
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Nicolás Marcelo
authors.initials: NM
authors.lastname: Vitale
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Stalldecker
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Valeria
authors.initials: V
authors.lastname: De Miguel
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Dora
authors.initials: D
authors.lastname: Cornaló
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Analía
authors.initials: A
authors.lastname: Alfieri
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: María
authors.initials: M
authors.lastname: Susana
authors.affiliation: Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinología de la Sociedad Argentina de Endocrinología y Metabolismo, Buenos Aires), Díaz Velez, Buenos Aires, 1200, Argentina.
authors.forename: Mallea
authors.initials: M
authors.lastname: Gil
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D015175:Prolactinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies