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Gender differences in presentation and outcome of nonfunctioning pituitary macroadenomas
Author(s) -
Caputo Carmela,
Sutherland Tom,
Farish Stephen,
McNeill Peter,
Ng Kong W.,
Inder Warrick J.
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12009
Subject(s) - hormone , medicine , presentation (obstetrics) , pituitary adenoma , retrospective cohort study , hormonal therapy , adenoma , physiology , surgery , cancer , prostate cancer
Summary Objectives Few data exist regarding gender differences in hormonal outcomes in nonfunctioning pituitary macroadenomas ( NFPMA ). The aim was to assess whether there are gender differences in hormonal outcomes in NFPMA following pituitary surgery at a single centre. Design and methods Retrospective review of cases undergoing a first surgical procedure for NFPMA . Preoperative hormonal function was available for 122 cases at presentation and 94 cases 6 months postoperatively. Multiple hormone deficiency was defined as ≥2 hormonal axis losses. Tumour size and invasion on MRI scan were assessed independently by a single neuroradiologist. Results At presentation, men were more likely than women to have multiple hormonal deficiency (47% vs 28%, P = 0·038). Premenopausal women tended to have smaller adenomas than men, but neither adenoma size nor invasion was associated with multiple hormonal deficiency at presentation. Postoperatively, differences were observed with only 14% of premenopausal women exhibiting multiple hormone deficiency, compared with 36% of postmenopausal women and 46% of men ( P = 0·03). Overall, postoperative hormonal recovery was observed in over one‐third of cases. Greatest recovery occurred in the gonadal axis of 60% (6/10) premenopausal women compared with 19% (8/43) of other groups combined ( P = 0·007). Conclusions Premenopausal women with NFPMA appear to have favourable hormonal outcomes. This may be due to a complex interplay between smaller tumour size and shorter disease duration. There should be no hesitation in offering pituitary surgery to premenopausal women with NFPMA , who have the most to gain in terms of restoration of hormonal function.