Characteristics of Pituitary Tumors Including Non-Functioning Tumors - a Tertiary Care Center Experience

Pituitary tumors compromise 10-20% of intracranial tumors. Non-functioning pituitary adenomas (NFPAs) are benign neoplasms which constitutes about 1/3rd of the pituitary tumors. There is few data on the characteristics of non-functioning tumors comparing with functioning tumors. Wide spread availability of MRI has eased the diagnosis of non-functioning tumors and early diagnosis. Objectives: To study the characteristics of pituitary tumors and the incidence of non-functioning tumors and compare with functioning tumors presenting to a tertiary care center. MethodsA retrospective study including 146 individuals with pituitary tumor were included from 2014 to 2020. Results: The study included 62(42.5%) male and 84(57.5%) female. The mean age was 41.97 + 13.93 years in males and 39.88 + 16.12 years in females. The mean duration of symptoms prior to presentation was 7.52 + 7.12 months and 10.37 + 11.60 months in males and females respectively. Macroadenoma (size >1cm) incidence was more with 55(88.7%) in males and 58(69%) in females. More number of males (87.1%) underwent surgery when compared to females (64.3%)(p – 0.002). There was more number of suprasellar and invasion of pituitary tumors seen in males compared to females(P- <0.01). There was no significant difference between various parameters like TSH, T4, LH, FSH, prolactin, Electrolytes, cortisol, ACTH, GH and IGF1 between males and females(p- NS). Seventy percent (103) of them were non-functioning tumors. Functioning tumors included 7(4.8%) acromegaly, 8(5.5%) cushings disease, 2(1.4%) gonadotropinoma, 24(16.4%) prolactinoma and 2(1.4%) posterior fossa tumor. Mean age in non- functioning tumors was 43.74 + 15.5 years. Mean diameter of tumor in non-functioning tumors was 21.04 + 11.54 cm when compared to functioning tumors (17.03 + 10.33 cm)(p- 0.61). Most of the patients with non-functioning tumors who underwent surgery received post operatively hydrocortisone and levothyroxine when compared to patients with functioning tumors(p < 0.01). There was no significant difference in terms of gender, suprasellar extension, invasion and pituitary hormones(p-NS). ConclusionMost of the pituitary tumors in our study were macroadenomas with more number of males undergoing surgery as most of them had suprasellar extension and invasion. Non- functioning tumors should be followed up regularly as most of them required hydrocortisone and levothyroxine post-operatively.