MON-LB076 Patterns of Secondary Hormonal Deficiency Vary among Different Types of Sellar Masses Despite Similar Tumour Size at Presentation

Abstract

BACKGROUND: Secondary hormonal deficiency (SHD) is common in patients with sellar masses (SM); however, it is unclear if the rate and type of SHD at presentation is related to the size or type of SM. We conducted a study comparing SHD in various SM based on pathology and size at presentation. METHODS: A retrospective analysis of all SM in a tertiary care neuropituitary program, enrolled between November 2005 and December 2018, was conducted based on type of SM and maximum tumor size, comparing rate of secondary hypogonadism (SHG), secondary hypothyroidism (SHT), secondary hypoadrenalism (SHA), growth hormone deficiency (GHD) and diabetes insipidus (DI). RESULTS: A total of 914 patients were identified including: nonfunctioning adenoma (NFA) = 346, prolactinoma (PRLoma) = 261, growth hormone (GH) adenoma = 51, ACTH adenoma = 36, meningioma = 57, craniopharyngioma (cranio) = 70 and Rathke’s cleft cyst (RCC) = 93. SM were further subdivided based on initial size into < 9mm (group A), 10-19mm (group B), 20-29mm (group C) and ≥ 30 mm (group D). The overall SHD (%), single vs. multiple SHD (%) and most prevalent SHD, respectively, for each group were as follow. Group A - NFA (10%, 56% vs. 44%, SHG and SHT), PRLoma (48%, 90% vs. 10%, SHG), GH adenoma (13%, 100% vs 0, SHG), ACTH adenoma (29%, 83% vs. 17%, SHG), cranio (50%, 100% vs. 0, GHD) and RCC (11%, 100% vs. 0, SHG); Group B - NFA (35%, 43% vs. 57%, SHG), PRLoma (73%, 77% vs. 23%, SHG), GH adenoma (23%, 71% vs. 29%, SHG), ACTH adenoma (30%, 67% vs. 33%, SHG), meningioma (5%, 0 vs. 100%, SHG and SHA), cranio (48%, 73% vs. 27%, SHT), RCC (17%, 43% vs. 57%, SHT); Group C - NFA (64%, 28% vs. 72%, SHG), PRLoma (78%, 50% vs. 50%, SHG), GH adenoma (75%, 50% vs. 50%, SHG), ACTH adenoma (100%, 33% vs. 67%, SHG), meningioma (16%, 100% vs. 0, SHT), cranio (70%, 38% vs. 62%, SHG), RCC (41%, 29% vs. 71%, SHG): Group D - NFA (83%, 40% vs. 60%, SHG), PRLoma (100%, 47% vs. 53%, SHG), GH adenoma (80%, 0 vs. 100%, SHG and SHT), meningioma (27%, 75% vs. 25%, SHG), cranio (88%, 36% vs. 64%, SHG) [all p <0.001]. CONCLUSION: This is the first study to show that SHD patterns vary considerably in various SM of similar size at presentation. While there is a higher risk of SHD in larger SM, the pattern of SHD is also dependent upon the underlying pathology. Of the two largest categories i.e., NFA and PRLoma, NFA are more likely to present with multiple SHD while PRLoma predominantly present with single SHD. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.