Pituitary apoplexy: a comprehensive analysis of 93 cases across functioning and non-functioning pituitary adenomas from a single-center
Authors' conclusion
PA in FPA has distinct features and management issues. Carefully selected patients (PAS guided) in NFPA with PA for conservative management have comparable outcomes to surgery.
Study context
- Population
- Patients with pituitary apoplexy managed at a tertiary endocrine centre33.3% functioning pituitary adenoma (FPA)
- Participants
- 93 patients
- Exposure
- Pituitary apoplexy in FPA vs NFPA; surgical vs conservative management
- Outcome
- Features and management of pituitary apoplexy
Methodological detailssingle-centre, record review
- Single-centre
- Record review
Main finding
As reported in the abstract
- Median age, years
- 40
- Type A (acute) presentation
- 49.5%
- Headache
- 78.5%
- Pituitary apoplexy (PA) as initial manifestation in NFPA
- 98.4%
- Median (range) Pituitary Apoplexy Score (PAS)
- 2 (0-8)
- Median tumour diameter
- 2.5 cm
- Larger tumours in FPA vs NFPA
- 3.2 cm vs. 2.3 cm
- Conservatively managed, NFPA
- 29 (46.7%)
- Conservatively managed, FPA (71% prolactinoma, 33% Cushing's Disease (CD), none acromegaly)
- 14 (45.2%)
Observational data: associations, not effects.
Further findings
NFPA: surgical vs conservative management
- Higher PAS with surgery vs conservative
- 4 vs. 1
- Larger tumour size with surgery vs conservative
- 2.6 vs. 1.8 cm
- Comparable recovery of neuro-visual, radiological and hormonal outcomes
FPA management
- CD and acromegaly required definitive treatment; prolactinomas effectively managed with oral cabergoline and glucocorticoids
PAS-matched macroadenomas (excluding prolactinoma): surgical vs conservative
- Comparable neuro-deficit and hormonal recovery
- Matched PAS cohorts
Original publication
Pituitary apoplexy: a comprehensive analysis of 93 cases across functioning and non-functioning pituitary adenomas from a single-center. Pituitary. Published 13 September 2024. doi:10.
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