Primary signs of pituitary macroadenomas of diff erent hormonal activity and specialists to whom patients referred at the fi rst time

Abstract

Purpose: evaluate the fi rst complaints of patients with pituitary macroadenomas, as well as the specialization of doctors, to whom they referred at the fi rst time.Material and methods: data of medical records of 343 patients with pituitary macroadenomas (at least one tumor size >10 mm) were analyzed: non-functioning pituitary adenomas (NFPA, n=143), prolactinomas (n=67), somatotropinomas (n =133). Patients were examined prior to any treatment.Results: In total, the most common fi rst complaints of patients with pituitary macroadenomas were: headache - 137/343 (40%), visual impairment - 86/343 (25%), general weakness and fatigue - 69/343 (20.1%), in female patients of reproductive age - menstrual irregularities. Headache did not depend on tumor size and volume, while visual disturbances were more common in patients with larger tumor volume and MR signs of chiasm compression. Th e most oft en patients with pituitary macroadenomas referred to: a neurologist 91/343 (26.5%), an ophtalmologist 44/343 (12.8%), 44/265 (16.6%) a gynecologist and a general practitioner – according to 41/343 (12%).Conclusions: A neurologist, ophthalmologist, gynecologist, and general practitioner should be aware of a pituitary macroadenoma in patients with headaches, visual disturbances, menstrual disorders (in women of reproductive age) and non-specific general complaints that may be a marker of the presence of a pituitary tumor macroadenoma.

Keywords

• pituitary macroadenomas
• nfpa
• prolactinoma
• acromegaly
• fi rst complaints
• primary specialist