Magnitude, Clinical Presentation and Outcome of Patients with Pituitary Lesions:An Experience from Tikur Anbessa Specialized Hospital, Ethiopia

Abstract

Background: Pituitary tumors are frequently encountered intracranial neoplasms. The prevalence of these tumors in autopsy series is reported to be significant in many studies. However, there are no adequate studies on magnitude, clinical presentation and outcome of pituitary lesions in our country. Patients and methods: A retrospective study, data collected using chart review was conducted at national endocrine referral clinics of the hospital. A five years data from June 2010 to June 2015 was collected. The patients’ clinico-demographic and radiologic features were documented using a prestructured data collection tool. Data was entered into SPSS version 20 and analyzed. Frequencies and means were computed for description of the various variables. Individuals aged 14 years and above from both sexes who started follow-up in the study years at Tikur Anbessa Specialized Hospital Endocrinology Clinics were included in the study. Results: Out of the total of 1124 patients seen at endocrine clinics 51 (4.54%) were diagnosed to have pituitary lesions. A total of 42 patients with confirmed pituitary lesions were included in the analysis out of which 30 (71.4%) were females and 12 (28.6%) were males. The age range was 14 to 60 years old (mean age was 32.5 years). Among the 42 patients 20 (47.6%) had prolactinoma, 9 (21.43%) Cushing’s disease, 7 (16.67%) acromegaly, 2 (4.76%) features of both prolactinoma and acromegaly, 2 (4.76%) panhypopituitarism, 1 (2.38%) hypogonadism and 1 (2.38%) nonfunctional pituitary adenoma. The most common presenting symptoms were headache in 33(78.6%) and visual disturbances in 20(47.6%) of patients. Among the 42 patients 26 (61.9%) had pituitary macroadenoma, 5 (11.9%) pituitary microadenoma, 7 (16.7%) normal Magnetic Resonance Imaging (MRI) and 4 (9.5%) of patients had no MRI. Of all patients included in the analysis 24 (57.1%) were treated medically only to control hormone secretion, 11(26.2%) patients were referred for surgical intervention and the rest were treated with both medical and surgical approaches or with regular follow-up only. Most of the patients with prolactinoma (80%) had improvement with medical treatment only. Conclusion: Pituitary lesions accounted 4.54% of endocrine patients and Prolactinomas were the most common followed by Cushing’s disease and Acromegaly. The patients with Prolactinomas had a good outcome with medical treatment only.