INTRODUCTION: Pituitary tumors specifically pituitary adenomas are not extremely rare conditions. They may be encountered by internists, opthalmologists, neurologists or even general practitioners. Pituitary tumors may present with space-occupying symptoms or may result in hormone dysfunction, which may be clinically manifested, in various ways depending on the hormones involved.
OBJECTIVES: This study aims to describe the prevalence, clinical profile and management of patients with pituitary tumors at St. Lukes Medical Center from January 1997 to September 2000.
METHODOLOGY: Retrospective Study
RESULTS: Medical records of forty-five patients were reviewed. In this study, males (49 percent) and females (51 percent) are almost equally affected, mostly belonging to the 31 to 60 years age group. Majority presented with visual disturbances (35 percent) and headache (28 percent). Imaging studies described the lesion as pituitary adenoma in 73 percent of the cases. The most common hormonal abnormalities were decreased cortisol and thyroid stimulating hormone followed by elevated prolactin levels. Among the 10 cases with immunohistostains, the majority (70 percent) were non-functioning. Only 30 percent had a preoperative diagnosis of functioning tumor. Two cases presented with acromegally, which revealed growth hormone secreting tumor on immunohistostain while one case presented with decreased libido, which revealed an FSH secreting tumor. Two prolactin-secreting tumors neither presented with amenorrhea nor galactorrhea. Seventy six percent of the patients underwent surgery mostly through transphenoidal approach (49 percent). Eleven percent had subsequent gamma knife stereotactic radiation surgery after craniotomy. Most of the patients claimed to have visual improvement after surgery. Medical management included hormone replacement. Pituitary adenoma was the most common histopathologic finding. The average number of days of confinement was eight days for those who underwent surgery and less than five days for those who underwent endoscopic transphenoidal technique. Majority of the post-operative course were unremarkable.
CONCLUSION: Whenever visual disturbances, headache and clinical signs of hormonal abnormalities are encountered in a patient, pituitary tumor specifically pituitary adenomas should be a consideration so that appropriate work-ups and management can be instituted. Management may be surgical, medical radiotherapy or a combination. Overall morbidity is low. Post-operative complications are minimal. Prognosis is good, however, vigilant monitoring as well as good patient compliance are essential for a successful therapeutic outcome.