論文

本文へのリンクあり
2021年

A survey of surgically resected pituitary incidentalomas and a comparison of the clinical features and surgical outcomes of non-functioning pituitary adenomas discovered incidentally versus symptomatically

Endocrine Journal
  • Mayo Ono
  • ,
  • Izumi Fukuda
  • ,
  • Akimi Soga
  • ,
  • Shigeyuki Tahara
  • ,
  • Akio Morita
  • ,
  • Hitoshi Sugihara

68
5
開始ページ
561
終了ページ
571
記述言語
掲載種別
研究論文(学術雑誌)
DOI
10.1507/endocrj.EJ20-0335

Pituitary tumors are discovered either incidentally by imaging studies (incidentalomas) or via evaluation of certain clinical symptoms (symptomatic tumors). In this study, we first surveyed patients with incidentalomas who underwent surgery. Cases included 62.3% non-functioning adenomas (NFPAs), 14.5% functioning adenomas, and 13.8% Rathke’s cleft cysts. Next, we compared the clinical features and surgical outcomes of 145 patients whose preoperative diagnosis was NFPA (incidentalomas [n = 79] vs. symptomatic tumors [n = 66]). The patients with incidentalomas were older (59.9 vs. 55.3 years, p < 0.05) and had smaller tumors compared with the patients with symptomatic tumors (mean maximum diameter: 23.1 vs. 27.5 mm, p < 0.01). The main reason for undergoing imaging studies was headache (n = 25) in the incidentaloma group and visual disturbance (n = 46) in the symptomatic tumor group. The incidence of preoperative pituitary hormone deficiencies was lower in the incidentaloma than symptomatic tumor group (growth hormone deficiency: 37.7% vs. 66.7%, p < 0.01; gonadotropin deficiency: 19.0% vs. 39.4%, p < 0.01; adrenocorticotropic hormone deficiency: 3.8% vs. 18.2%, p < 0.01; thyroid stimulating hormone deficiency: 6.3% vs. 12.1%, p = 0.25). Postoperative pituitary function was better preserved in the incidentaloma than symptomatic tumor group (no deficiency: 58.2% vs. 28.8%, p < 0.01). The difference in postoperative complications between groups was not statistically significant (incidentalomas vs. symptomatic tumors: 21.5% vs. 19.7%, p = 0.84). In conclusion, incidentalomas were detected while smaller size and lower incidence of hormone deficiency than symptomatic tumors, and the pituitary hormones were also preserved after surgery. It is important to observe incidentalomas carefully and to judge whether to operate appropriately before they become symptomatic tumors.

リンク情報
DOI
https://doi.org/10.1507/endocrj.EJ20-0335
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33504715
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85107319103&origin=inward 本文へのリンクあり
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85107319103&origin=inward
ID情報
  • DOI : 10.1507/endocrj.EJ20-0335
  • ISSN : 0918-8959
  • eISSN : 1348-4540
  • PubMed ID : 33504715
  • SCOPUS ID : 85107319103

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