title: Sellar Masses: An Epidemiological Study.
abstract: BACKGROUND
  Sellar masses (SM) are mostly benign growths of pituitary or nonpituitary origin that are increasingly encountered in clinical practice. To date, no comprehensive population-based study has reported the epidemiology of SM from North America.
  
  
  OBJECTIVE
  To determine the epidemiology of SM in the province of Nova Scotia, Canada.
  
  
  METHODS
  Data from all pituitary-related referrals within the province were prospectively collected in interlinked computerized registries starting in November 2005. We conducted a retrospective analysis on all patients with SM seen within the province between November 2005 and December 2013.
  
  
  RESULTS
  A total of 1107 patients were identified, of which 1005 were alive and residing within the province. The mean age at presentation was 44.6±18 years, with an overall female preponderance (62%) and a population prevalence rate of 0.1%. Of patients with SM, 837 (83%) had pituitary adenomas and 168 (17%) had nonpituitary lesions. The relative prevalence and standardized incidence ratio, respectively, of various SM were: nonfunctioning adenomas (38.4%; 2.34), prolactinomas (34.3%; 2.22), Rathke's cyst (6.5%; 0.5), growth hormone-secreting adenomas (6.5%; 0.3), craniopharyngiomas (4.5%; 0.2), adrenocorticotropic hormone-secreting adenomas (3.8%; 0.2), meningiomas (1.9%), and others (3.9%; 0.21). At presentation, 526 (52.3%) had masses ≥1 cm, 318 (31.6%) at <1 cm, and 11 (1.1%) had functioning pituitary adenomas without discernible tumor, whereas tumor size data were unavailable in 150 (14.9%) patients. The specific pathologies and their most common presenting features were: nonfunctioning adenoma (incidental, headaches, and vision loss), prolactinomas (galactorrhea, menstrual irregularity, and headache), growth hormone-secreting adenomas (enlarging extremities and sweating), adrenocorticotropic hormone-secreting adenoma (easy bruising, muscle wasting, and weight gain) and nonpituitary lesions (incidental, headaches, and vision problems). Secondary hormonal deficiencies were common, ranging from 19.6% to 65.7%; secondary hypogonadism, hypothyroidism, and growth hormone deficiencies constituted the majority of these abnormalities.
  
  
  CONCLUSIONS
  This is the largest North American study to date to assess the epidemiology of SM in a large stable population. Given their significant prevalence in the general population, more studies are needed to evaluate the natural history of these masses and to help allocate appropriate resources for their management.
authors.affiliation: 1Department of Medicine,Tawam Hospital in affiliation with Johns Hopkins,Al Ain,United Arab Emirates.
authors.forename: Khaled
authors.initials: K
authors.lastname: Al-Dahmani
authors.affiliation: 2Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: Syed
authors.initials: S
authors.lastname: Mohammad
authors.affiliation: 2Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: Fatima
authors.initials: F
authors.lastname: Imran
authors.forename: Chris
authors.initials: C
authors.lastname: Theriault
authors.affiliation: 3Division of Endocrinology,Department of Medicine,Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Doucette
authors.affiliation: 4Department of Medicine,Cape Breton Regional Hospital,Sydney,Nova Scotia,Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Zwicker
authors.affiliation: 3Division of Endocrinology,Department of Medicine,Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: Churn-Ern
authors.initials: CE
authors.lastname: Yip
authors.affiliation: 5Division of Neurosurgery,Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: David B
authors.initials: DB
authors.lastname: Clarke
authors.affiliation: 3Division of Endocrinology,Department of Medicine,Dalhousie University,Halifax,Nova Scotia,Canada.
authors.forename: Syed Ali
authors.initials: SA
authors.lastname: Imran
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D010911:Pituitary Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D012042:Registries
keywords: pituitary adenomas; pituitary tumo