Incidence of pituitary incidentalomas in patients with adrenal adenomas.
With the advent of modern imaging modalities, endocrine incidentalomas are increasingly being discovered. We aimed to investigate the presence of pituitary incidentalomas (PI) in patients with adrenal incidentalomas (AI), and identify potential metabolic correlates in this cohort. 26 patients (18 females) with AI discovered on abdominal computerized tomography were studied. All patients underwent pituitary magnetic resonance imaging (MRI) and endocrine investigations to evaluate functional adrenal pathology, anterior pituitary hormonal status, insulin-resistance indices and presence of metabolic syndrome. Pituitary MRI revealed a microadenoma and a 4×5 mm cyst in 1 patient respectively, and an empty sella in 4 (2 partial) patients. Overall, 6/26 (23%) patients with an AI had evidence of pituitary imaging pathology but only 8% had a PI; none had any evidence of abnormalities in pituitary function. Subclinical hypercortisolism was the only hyperfunctional status detected in 4 patients with AI but was unrelated to the pituitary findings. No abnormality of insulin secretion and action was found between patients with or without pituitary pathology. In the present study 23% of patients with AI had some alteration in pituitary morphology, and 2 a PI without accompanying pituitary hormonal deficit or metabolic derangement. Further studies are required to address this issue and identify a potential pathogenetic mechanism.
Unit of Endocrinology, Theagenio Hospital, Thessaloniki, Greece.
A
A
Chrisoulidou
Unit of Pathophysiology, Laiko Hospital, Athens, Greece.
K I
KI
Alexandraki
Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece.
M
M
Kita
Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece.
K
K
Tsolakidou
Unit of Endocrinology and Diabetes, "G. Genimatas" Hospital, Athens, Greece.
L
L
Papanastasiou
Unit of Radiology, "G. Genimatas" Hospital, Athens, Greece.
C
C
Samara
Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece.
A
A
Anastasiou
Unit of Endocrinology and Diabetes, "G. Genimatas" Hospital, Athens, Greece.
G
G
Piaditis
Unit of Pathophysiology, Laiko Hospital, Athens, Greece.
G
G
Kaltsas
D000236:Adenoma / Q000150:complications* / Q000453:epidemiology*; D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000453:epidemiology*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000453:epidemiology*