Calcification in pituitary adenomas

Abstract

Though radiographically-proven calcifications in pituitary adenomas are rare, a higher incidence of microscopically-proven calcified adenomas has been recently reported. Therefore, the incidence of radiological and microscopical calcifications in various types of pituitary adenomas in a consecutive series of 169 cases (71 acromegalies, 54 prolactinomas, 24 Cushing's diseases, 2 FSH-producing adenomas, 1 TSH-producing adenoma and 17 non-functioning adenomas) were reviewed. Intra or supra-sellar calcifications visible on plain skull films or sellar tomograms were counted only in 4 cases (3 prolactinomas and 1 acromegaly). Including these 4, 22 of the 169 cases had microscopicallyproven calcifications, the majority (20 cases) were prolactinomas and only 2 acromegalies. Histologically, these calcifications in pituitary adenomas were divided into 3 types; that is, 1) calcifications in the intratumoral hematoma, 2) calcifications in the degenerative adenoma tissue, and 3) scattered psammoma bodies between the adenoma cells. The last type of calcification seemed to be characteristic of almost all of the calcified prolactinomas. The first and second types of calcification were seen in 2 cases of acromegaly, and were thought to be the result of degenerative or hemorrhagic change of the adenoma. No significant differences between calcified and non-calcified prolactinomas were detected as regards serum PRL levels, the length of hyperprolactinemic state, patient's age and sex, or operative findings.