title: Epidemiology and radiological geometric assessment of pituitary macroadenomas: population-based study.
abstract: Pituitary adenomas are relatively common tumours with diverse clinical features. Epidemiological data are important to help quantify health burden.
  
  
  
  To provide in-depth epidemiological data on macroadenomas and radiologically characterize macroadenomas.
  
  
  
  Population-based retrospective analysis, Prevalence as at 2014; Incidence based on data from 2000 to 2014, Retrospective analysis of baseline MRI.
  
  
  
  The Maltese islands.
  
  
  
  173/136 patients with macroadenomas for prevalence/incidence estimates respectively, 122 baseline MRI for radiological characterization.
  
  
  
  Prevalence rates, Standardized Incidence rates (SIR), MRI findings.
  
  
  
  The prevalence for macroadenomas was 40·67/100 000 people and the SIR was 1·90/100 000/year. Giant pituitary adenomas (>40 mm) constituted 4·8% of the whole cohort of PAs and the SIR was 0·18/100 000/year. Giant prolactinomas constituted 4·7% of all the prolactinomas and the SIR was 0·07/100 000/year, while giant NFPA constituted 6·0% of all NFPA and the SIR was 0·12/100 000/year. There was a statistically significant difference in the degree of suprasellar extension (P < 0·001) and infrasellar extension (P = 0·028) between the different macroadenoma subtypes and in the vertical extension indices (median vertical extension index NFPA 3·0 mm; PRLoma -7·7 mm; GH-secreting PA -1·7 mm; P < 0·001). Pituitary macroadenomas with cavernous sinus invasion were statistically significantly larger than those without cavernous sinus invasion (P < 0·001). NFPA had predominantly a superior extension into the cavernous sinus (63·6%) compared to the functional PAs which had predominantly an inferior extension into the cavernous sinus (59·1%) (P = 0·032).
  
  
  
  The various macroadenoma subtypes' epidemiological data are presented and differences between growth patterns among the various subtypes are highlighted.
authors.affiliation: Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Mater Dei Hospital, Msida, Malta.|Neuroendocrine Clinic, Mater Dei Hospital, Msida, Malta.
authors.forename: Mark
authors.initials: M
authors.lastname: Gruppetta
authors.affiliation: Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Mater Dei Hospital, Msida, Malta.|Neuroendocrine Clinic, Mater Dei Hospital, Msida, Malta.
authors.forename: Josanne
authors.initials: J
authors.lastname: Vassallo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008319:Malta / Q000453:epidemiology; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D015175:Prolactinoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies