Abstract

MONCET, D; MORENO FERNANDEZ, MJ  and  ISAAC, G. Pituitary tumors in the elderly. Rev. argent. endocrinol. metab. [online]. 2010, vol.47, n.1, pp.21-26. ISSN 1851-3034.

World population has been growing and aging; and pituitary tumors prevalence among the elderly has also increased, summing up to 10-15% of all pituitary tumors. Thirty six elderly patients with pituitary tumors, 20 of them male, were evaluated restrospectively (average age 71 years, range 65-85). A non-functioning adenoma (NFA) prevalence was reported in 64% of the cases, followed by acromegaly, prolactinoma and one each of Cushing´s disease, lymphocytic hypophysitis, craniopharyngioma, and Rathke's pouch cyst. Macroadenomas accounted for 89% of tumors and the most frequent presentation was through visual disorders symptoms followed by incidental finding and hormone hypersecretion. During biochemical evaluation, most patients presented different degrees of hypopituitarism, and patients with macroprolactinoma had PRL levels>800ng/ml. Twenty one patients (58%) underwent surgery, while 9 underwent radiotherapy. During the 3.6 years follow-up, changes in adenoma size were reported in 3 patients who received no treatment (in 2 cases size increased, whereas in another it decreased). Medical treatment was indicated for those whose pathology persisted or as primary treatment if comorbilities prevented from performing a surgery. No pituitary function improvement was detected after surgery and the appearance of one or more deficiency was noticed in 62% of patients, though visual field did improve in 67%. Definitive diabetes insipidus as a complication was only detected in two patients, and a case of fistula and meningitis was observed. As a conclusion, we reported a NFA prevalence rate smaller than that reported in the world literature, though similar for the other pituitary tumors, and a higher rate of incidental presentation. No complications attributable to patients' age group were detected during surgery. For elderly patients who do not undergo surgery, clinical and imaging follow-up and/or medical treatment could be an option of choice.

Keywords : Pituitary tumor; Elderly; Macroadenoma.

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