FRI304 Prolactinomas In A Pituitary Center From Ecuador: Clinical Presentation With High Prevalence Of Giant Adenomas And Delayed Diagnosis

Abstract

Abstract Disclosure: D.P. Quishpe Lopez: None. G.C. Freire Salazar: None. M.V. Villagomez Estrada: None. R.M. Ruiz Urbaez: None. S.A. Baquero Contreras: None. R.D. Mino Rodriguez: None. J.L. Salazar Vega: None. Background: Prolactinomas are the most common pituitary neuroendocrine tumors (PitNET) and account for about 50% of cases. Most of them respond favorably to pharmacological treatment (cabergoline). Epidemiological data in our country are scarce and more reports are needed. The aim of this study was to analyze the clinical presentation of patients with prolactinomas in a tertiary center. A cross-sectional study was performed (November 2021 - December 2022) analyzing information from clinical records. Results: Seventy-nine patients were included, mean age at diagnosis 29.5 years (SD 12.09, range 11-65) of which the majority were women (63.3%). Due multiple factors the diagnosis was delay with a mean of 45.63 months (range 2-216). As variables related with the clinical manifestations of prolactinomas, overweight/obesity was recorded in 79.6% of the cases. The predominant reasons of attendance in women were galactorrhea 48%, menstrual alteration 22% and headache 20%. In men, in the other hand, were visual alteration 48.3% and headache 31%. The main components of hypopituitarism identified were hypogonadism 46.8% and central hypothyroidism 27.8%. Serum prolactin levels at diagnosis differed between macroprolactinomas and microprolactinomas from 5617 ng/mL (136-47000) to 140.17 ng/mL (68-278) respectively. We identified 27 (34.2%) microadenomas, 39 (49.4%) macroadenomas and 13 (16.5%) giant adenomas. Giant prolactinomas predominated in men (76.9%). There was a linear correlation between tumor size and hyperprolactinemia (Spearman correlation 0.87). Regarding initial treatment: 94.9% received pharmacological treatment. Only 5.1% underwent surgery (100% macroadenomas). Conclusion: Several factors and limitations in the public health system of Ecuador delay the timely diagnosis and treatment of pituitary tumors, affecting the quality of life of these patients. Being a national referral center, we receive a high percentage of macroprolactinomas and giant prolactinomas (65.9%). Within public health, this study is a reference to motivate future research and the development of a national guideline to optimize the management of prolactinomas. Presentation: Friday, June 16, 2023