Incidence Of Pituitary Adenomas Research Articles

Association between birth characteristics and incidence of pituitary adenoma and craniopharyngioma: a registry-based study in California, 2001–2015

PurposeTo evaluate the association between birth characteristics, including parental sociodemographic characteristics, and early-onset pituitary adenoma (PA) and craniopharyngioma.MethodsLeveraging the population-based California Linkage Study of Early-onset Cancers, we identified the birth characteristics of incident cases with PA (n = 1,749) or craniopharyngioma (n = 227) who were born from 1978 to 2015 and diagnosed 1988–2015, as well as controls in a 50:1 ratio matched on birth year. Adjusted odds ratios (OR) and 95% confidence interval (CI) estimates were computed using unconditional multivariable logistic regression.ResultsMales had a lower risk of PA than females (OR = 0.37, 95%CI: 0.34–0.41), and Black (OR = 1.55, 95%CI: 1.30–1.84) or Hispanic (OR = 1.53, 95%CI: 1.34–1.74) individuals had a higher risk compared to non-Hispanic Whites. Older maternal age was positively associated with PA (OR = 1.09, 95%CI: 1.04–1.15 per 5 years, p < 0.01), as was higher maternal education (OR = 1.12, 95%CI: 1.04–1.20 per year, p < 0.01). There were no statistically significant associations between birthweight (OR = 1.04, 95%CI: 0.99–1.09 per 500 g, p = 0.12), birth plurality, or birth order and PA. When stratified by race and ethnicity, the significant association with maternal education was identified only for non-Hispanic White individuals. On multivariable logistic regression, no statistically significant associations were identified between birth characteristics and incidence of craniopharyngioma, except that risk was higher among Hispanic (OR = 1.45, 95%CI: 1.01–2.08) compared to non-Hispanic White individuals.ConclusionIn this large, population-based study, female sex, older maternal age, higher maternal education, and Hispanic ethnicity and Black race compared to non-Hispanic White race, were associated with an increased risk of PA in children and young adults.

Correlation Analysis of Magnetic Resonance Imaging Characteristics and Prognosis of Invasive Pituitary Adenomas in Neurosurgery Hospitals.

The incidence of pituitary adenoma is second only to glioma and meningioma, and its incidence ranks third among intracranial tumors. Most pituitary adenomas are benign and noninvasive tumors, but invasive pituitary adenomas pose a great threat to human health. In order to explore the risk factors that affect the clinical aggressive behavior of patients with pituitary adenoma, analyze the correlation between different classification methods and clinical aggressive behavior, and lay the foundation for early judgment and individualized treatment of clinical aggressive behavior of patients with pituitary adenoma. We conducted statistical research on patients who were treated for pituitary adenomas in the city's Yangzhou Hongquan Hospital. The results of the study showed that six patients in this study showed aggressiveness in the clinical symptomatic outcome, six patients showed aggressiveness in the serological outcome, and seven patients showed aggressiveness in imaging. In the multimodal classification, the clinical aggressiveness of pituitary adenomas in the invasion + atypical group was significantly higher than that in other groups, and the difference was statistically significant (P < 0.05). The correlation analysis of magnetic resonance imaging features and prognosis of invasive pituitary adenomas were verified to be feasible for the treatment of patients.

Alcohol intake and risk of pituitary adenoma.

The association between alcohol intake and incidence of pituitary adenoma has not been reported previously. We examined this association in three large, prospective cohort studies. Using data from the Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-Up Study, we computed multivariable-adjusted hazard ratios (MVHR) and 95% confidence intervals (CI) for pituitary adenoma by levels of alcohol intake using Cox proportional hazards regression. We identified 292 incident cases of pituitary adenoma (225 among women, 67 among men) among 235,973 participants with 6,548,732 person-years of follow-up. Compared with intake of ≤ 0.5g/day, cumulative average alcohol intake in all categories was associated with reduced risk of pituitary adenoma (MVHR = 0.60, 95% CI 0.43-0.83 for 0.5-≤ 2g/day, MVHR = 0.57, 95% CI 0.41-0.79 for > 2.0-≤ 8.0, MVHR = 0.70, 95% CI 0.47-1.04 for > 8.0-≤ 15.0, and MVHR = 0.51, 95% CI 0.32-0.83 for > 15.0g/day). Significant inverse findings were present in women and were similar but non-significant in men. For specific alcoholic beverages, inverse associations were statistically significant for total wine (MVHR = 0.58, 95% CI 0.43-0.79 comparing 0.5-≤ 2 to ≤ 0.5g/day), red wine (MVHR = 0.65, 95% CI 0.46-0.92 comparing 0.5-≤ 2 to ≤ 0.5g/day), and white wine (MVHR = 0.72, 95% CI 0.53-0.97 comparing 0.5-≤ 2 to ≤ 0.5g/day). Results were consistent using baseline intake, recent intake, and with an 8-year lag. In three prospective cohorts, compared to almost no consumption, alcohol consumption was associated with reduced risk of pituitary adenoma. Sensitivity analyses suggest that these results are unlikely to be the result of reverse causation or diagnostic bias.

AACE2021-A-1063: Pituitary Adenoma: Epidemiology, Clinical, Biochemical, and Radiological Features

Pituitary adenoma (PA) is defined as an abnormal growth in the anterior pituitary gland. pituitary adenomas represent about 15% of all intracranial tumours. This study aimed to find out the incidence of pituitary adenoma in patients admitted to Sultan Qaboos University Hospital (SQUH) in adult patients (>20 years old). This research could lead to decrease morbidity and mortality rates of PA and a better understanding of the true disease burden and its management.

Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004\u20132016

Comprehensive investigations on the incidence and prognosis of pituitary tumors are still lacking. The present study aims to summarize the incidence, demographics, and survival outcome of pituitary adenoma on a population-based level. This study includes all pituitary adenomas reported in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016 in the United States. Extensive clinical and demographic characteristics were extracted and submitted to group comparisons. The standardized incidence rate was calculated and stratified by year at diagnosis, age/sex and age/treatment groups. The Kaplan–Meier analysis and multivariable regressions were performed to identify the factors associated with overall survival. A total of 47,180 pituitary tumors were identified, including 47,030 typical adenomas, 111 uncertain behavior pituitary adenomas, and 39 pituitary carcinomas. The overall standardized incidence rate was 4.8 cases per 100,000 person-years and the annual incidence rate continually trended upwards, with a peak seen in 2015. We noticed a bimodal age-related distribution in females and a unimodal distribution in males. In the multivariate regression analysis, the factors associated with prolonged survival included typical adenoma, younger age, and smaller tumor size. Whereas, black and male patients had worse overall survival. Our study provides a reliable estimate on the incidence of pituitary adenoma and confirms that the annual standardized incidence rate is increasing. Pituitary adenomas have a satisfactory long-term prognosis and age, tumor size, and tumor subtypes are related to overall survival. Though statistically significant, our inferential findings should be constrained within the limitations of SEER database.

Pituitary surgery in elderly patients: a safe and effective procedure.

The incidence of pituitary adenoma (PA) increases with age. Transsphenoidal surgery (TSS) in elderly patients is often considered to have greater risk compared to the younger population. The aim of this study is to compare surgical results, evolution and postoperative complications between elderly and young patients undergoing TSS. Retrospective review of patients undergoing TSS between 2011 and 2018 in our institution. Patients were divided into two cohorts: elderly (≥65 years) and non-elderly (<65 years). Characteristics and outcomes of both groups were compared at diagnosis, before surgery and for an average of 5.9 years of postoperative follow-up. One hundred and twenty-five patients were included, 53 patients were ≥65 years (42%). The elderly patients were more likely to have non-functioning PA (NFPA) (90.5% vs. 45.8%, p: <0.01), a higher proportion of macroadenomas (92.4% vs. 77.8%, p = 0.029) and greater extrasellar extension (88.7% vs. 68.1%, p = 0.007). The elderly group also had more compressive symptoms (54.7% vs. 34.7%, p = 0.035) and hypopituitarism (66% vs. 47.2%, p = 0.029). Overall, surgical and endocrinological outcomes between the two groups were similar. Inpatient mortality in the elderly group was 1.8%. Regarding long-term outcomes, elderly patients had more postoperative hypopituitarism (67.9% vs. 45.8%, p = 0.03) with no differences in permanent diabetes insipidus, less residual tumours (24.5% vs. 40.3%, p = 0.019) and a higher rate of remission after surgery (71.7% vs. 52.8%, p = 0.034). When only NFPA cases were compared, the only significant difference was a higher frequency of macroadenomas in the elderly group. Our results support the safety and efficacy of TSS in elderly patients with PA. Age should not be considered an exclusion criterion for TSS given that successful results can be achieved if an experienced pituitary team is available.

Exome Sequencing of Sporadic GH-Secreting Pituitary Adenomas

The incidence of pituitary adenomas in the population is approximately 1: 1000 [1], which is 15% of all intracranial neoplasms [2].

Transsphenoidal Approach for Pituitary Adenomas in Elderly Patients

With a rapidly expanding elderly population in the United States, the incidence of pituitary adenomas in elderly will continue to rise. In this study, we aim to evaluate the safety and efficacy of transsphenoidal endoscopic endonasal resection for pituitary adenomas in the elderly population. A retrospective review of 131 consecutive patients who underwent transsphenoidal endoscopic endonasal resection for pituitary adenomas at the University of Miami Hospital between 2012 and 2016 was performed. Preoperative, intraoperative, and surgical outcomes were analyzed in elderly (>70 years) versus nonelderly (<70 years) patients. Of the 131 patients, 23 of them were >70 years (18%), of which 14 were septuagenarians and 9 were octogenarians. Elderly patients were more likely to present with vision loss (80.8% vs. 56.6%; P= 0.013) and larger tumors on imaging (2.7 ± 1.0 cm vs. 2.4 ± 1.3 cm; P=0.042). Overall surgical and endocrinologic outcomes between the 2 groups were similar. However, patients <70years old were more likely to have a gross total resection (86.7% vs. 65.4%; P= 0.011), as well as transient diabetes insipidus (54.3% vs. 26.9% P= 0.012) and intraoperative cerebrospinal fluid leak (83.5% vs. 58.5%; P= 0.013). However, permanent postoperative complication rates were similar including rate of permanent diabetes insipidus (4.3% elderly vs. 12.1% adult), cerebrospinal fluid leak (8.7% elderly vs. 8.4% adult), and meningitis (4.3% elderly vs. 2.8% adult). There were no medical complications or deaths in our cohort. The transsphenoidal endoscopic endonasal approach can be a safe and effective technique for resection of pituitary adenomas in patients >70 years old with appropriate patient selection.

The incidence rate of pituitary adenomas in western Sweden for the period 2001-2011.

The number of studies on the incidence of pituitary adenomas (PAs) is limited. The aim of this study was to evaluate the standardised incidence rate (SIR) of PAs in western Sweden. Data from adult patients diagnosed with PAs in 2001-2011, living in the Västra Götaland County, were collected from the Swedish Pituitary Registry (SPR). In addition, medical records on all patients diagnosed with PAs at the six hospitals in the region were reviewed. In total, 592 patients were included in the study.Age-SIR, given as rate/100 000 inhabitants (95% CI), was calculated using the WHO 2000 standard population as a reference. The total SIR for PAs was 3.9/100 000 (3.6-4.3); 3.3/100 000 (2.9-3.7) for men and 4.7/100 000 (4.1-5.3) for women. In men, SIR increased with age, while in women SIR peaked at 25-34 years, mainly due to prolactinomas. Non-functioning PA (NFPA) was the most common PA (54%, 1.8/100 000 (1.6-2.0)) followed by prolactinomas (32%, 1.6/100 000 (1.3-1.9)), acromegaly (9%, 0.35/100 000 (0.25-0.45)), Cushing's disease (4%, 0.18/100 000 (0.11-0.25)) and TSH-producing PA (0.7%, 0.03/100 000 (0.00-0.05)). The proportion of macroadenomas for NFPA was 82%, prolactinomas 37%, GH-producing PA 77%, ACTH-producing PA 28% and TSH-producing PA 100%. The lifetime risk for PAs was 0.27% (0.24-0.31) in men and 0.29% (0.26-0.33) in women. This study provides a reliable estimate on the overall incidence of PAs and confirms an increased incidence of PAs compared with studies conducted in the pre-magnetic resonance imaging era. The lower proportion of prolactinomas compared with previous studies is probably explained by the different criteria used.

Epidemiology and etiopathogenesis of pituitary adenomas

Pituitary adenomas are usually benign monoclonal tumours presenting either due to hypersecretion of pituitary hormones, and/or due to local space occupying effects and hyposecretion of some or all of the pituitary hormones. Some pituitary adenomas cause prominent symptoms, while others may result in slowly developing, insidious, non-specific complains delaying accurate diagnosis, with a third group remaining symptomless and recognised only incidentally. Therefore, it is a challenge to accurately determine the prevalence and incidence of pituitary adenomas in the general population. The vast majority of pituitary adenomas occur sporadically, but familial cases are now increasingly recognised. Hereditary predisposition, somatic mutations and endocrine factors were shown to have a pathophysiologic role in the initiation and progression of pituitary adenomas, which interestingly almost always remain benign. Here, we summarize the available epidemiological data and the known pathogenesis of the pituitary adenomas.

Incidence of pituitary adenomas in Western Sweden in 2001--2011

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Pituitary adenomas in childhood and adolescence with a focus on intratumoral hemorrhage

Pituitary adenomas in childhood and adolescence are relatively rare. In the present study we investigated intratumoral hemorrhage in pituitary adenomas and examined cases of intratumoral hemorrhage using adult patients for comparison. From 1975 to 2012, 38 consecutive patients operated for pituitary adenoma and one patient treated with medication alone, were enrolled in this study. Their ages were less than 18years old at the initial diagnosis (mean age 15.3±2.9years). The comparison group consisted of 209 consecutive adult patients (>18years old). The incidence and characteristics of intratumoral hemorrhage in pituitary adenomas were evaluated, based on magnetic resonance imaging (MRI) findings (28 cases) and on operative findings. The incidence of pituitary adenomas in childhood and adolescence was 38/1,073 (3.5%) patients operated. Functioning pituitary adenomas (82.1%) were common and non-functioning pituitary adenomas (17.9%) were rare. Although no significant difference in tumor size was found and Knosp grade did not differ between young (≤18years old) and adult (>18years old) patients, indications of intratumoral hemorrhage on MRI was common in young patients (42.9%). Based on both MRI and operative findings, intratumoral hemorrhage was significantly more likely to occur in young patients, compared with adult patients.

Prevalence and incidence of pituitary adenomas: a population based study in Malta

Epidemiological data is important to correctly quantify the extent of disease and needed health care resources. The aim of the study was to establish the prevalence and incidence of pituitary adenomas (PAs) in the same well defined population, with in-depth analysis of the various subtypes. The design involved a retrospective cross-sectional analysis of PA patients diagnosed prior to 31 July 2011 for prevalence estimates and those diagnosed between July 2000 and July 2011 for incidence estimation. A thorough search for patients with PAs was carried out in central hospital registries including outpatients departments, surgical registries, radiological department and specialty clinic databases. Prevalence rates/100,000 and Standardised incidence ratios (SIR)/100,000/year were worked out. The respective prevalence rates and SIR for PAs overall were 75.7/100,000, and 4.27/100,000/year, for Prolactinomas 35.0/100,000 and 2.05/100,000/year, for nonfunctioning PA 25.9/100,000 and 1.79/100,000/year and for GH-secreting PAs 12.5/100,000 and 0.31/100,000/year. The overall prevalence for macroadenomas was 32.8/100,000 and SIR was 1.49/100,000/year. The prevalence rate in males for PAs overall was 46.3/100,000 and SIR was 2.08/100,000/year and in females 104.8/100,000 and SIR was 6.58/100,000/year. Females had a lower proportion of macroadenomas than males (29.5 vs. 75.0%; P < 0.001) and macroadenomas tended to present at a later age compared to microadenomas (48 vs. 34.5; P < 0.001). The highest SIR was reached in the 30-39 age group at 7.42/100,000/year. Our data confirm the considerable disease burden that PAs bear on health care resources. Males and females have similar prevalence and SIR rates for macroadenomas but there is a significant increase in SIR in females of child bearing age compared to males. These observations may have important implications in terms of the economic burden and need for early intervention.

Background Lesions during a 24-Month Observation Period in Connexin 32-Deficient Mice

Connexin 32 (Cx32) is a major gap junction protein in the liver. Neoplastic and non-neoplastic lesions were examined in Cx32-deficient (Cx32KO) mice maintained for 24-month, and compared with those in wild-type mice as a corresponding control. In neoplastic lesions, hepatocellular carcinoma increased significantly only in male Cx32KO mice, suggesting that Cx32 deficiency may be related to their pathogenesis. For females, the incidence of pituitary adenoma in the pars distalis of Cx32KO mice was lower than that of wild-type mice. No non-neoplastic lesions related to Cx32-deficiency were observed in the Cx32KO mice. In conclusion, these results demonstrate that the incidence of hepatocellular carcinoma increases only in male Cx32KO mice, presumably due to enhanced tumor promotion and progression signals associated with Cx32 deficiency.

Incidence and Treatment of Central Nervous System Tumors in Suriname

To estimate the incidence of central nervous system (CNS) tumors in Suriname. A retrospective chart review was performed at the Academic Hospital Paramaribo and the State Health Insurance foundation. Patients receiving a diagnosis of CNS tumor in the period 2000-2010 were included in the study if a computed tomography scan or magnetic resonance imaging study was available. Demographic data and patient characteristics and disease variables were retrieved. The study comprised 251 patients who met the inclusion criteria. The incidence of treated CNS tumors was 5 per 100,000 per year. There was a peak incidence in the 41-50 age group and a male-to-female ratio of 1:1.46. Of CNS tumors, 21% were gliomas, 26.7% were meningiomas, 4.7% were schwannomas, and 12.0% were pituitary adenomas. Suriname has a low glioma incidence compared with globally (40%-60% of CNS tumors globally). The incidence of pituitary adenoma was higher than expected. There are indications for a higher glioma and meningioma incidence in Javanese and a higher metastases incidence in Creoles. The annual incidence of treated CNS tumors of 5 per 100,000 inhabitants in Suriname was in accordance with the expectation of an incidence of 3-6 per 100,000. Suriname is considered a country with a low cancer incidence. The differences found among various subgroups were too small to make definitive statements.

Prevalence and incidence of pituitary adenomas

Reliable epidemiological data on pituitary adenomas (PAs) are of major importance for estimating the burden on the Health Care System and for designing optimal resource distribution for clinical care and for research activities. Cross-sectional studies from Switzerland, Belgium and the UK have shown that PAs have a prevalence of 78 to 94 cases/100,000 inhabitants (three to five times higher than previously thought). Furthermore, data from Northern Finland show an overall standardized incidence rate of 4 per 100,000 with the incidentally discovered ones demonstrating an increase. The enhanced awareness of pituitary disease and the recent advances in the diagnostic technologies have contributed to the earlier recognition of PAs. Studies from diverse populations and of larger sample size are needed to expand our insight on the epidemiology of PAs.

Pituitary Adenoma

Pituitary adenomas comprise approximately 10% to 20% of all central nervous system neoplasms whereas autopsy series have suggested that the incidence of pituitary adenoma in the general population may approach 25%. Several treatment modalities are used in the treatment of pituitary adenomas, including observation, surgery, medical intervention, and radiotherapy. The treatment modality employed depends greatly on the type of pituitary adenoma and presenting symptoms. This review will discuss the biology of pituitary adenomas and the current management principles for the treatment of prolactinomas, Cushing disease, acromegaly, and nonsecretory adenomas, with an emphasis on the published radiotherapeutic literature.

Incidence of Pituitary Adenomas in Northern Finland in 1992–2007

Data on the incidence of pituitary adenomas (PAs) are scant and outdated. A population-based regional cohort with thorough case identification was used to evaluate the incidence of clinically detected PAs in the era of magnetic resonance imaging. The objective of the study was to describe the age- and sex-specific incidence of all PA subgroups, with data on incidentally found PAs, pituitary apoplexies, and time trends. This was a retrospective descriptive analysis of PA patients diagnosed during 1992-2007 in Northern Finland (NFi). World Health Organization 2000-standardized incidence rates (SIRs) of PAs per 100,000 were measured. The final cohort consisted of 355 PAs. The incidence rates of the Oulu University Hospital regional district were used as a reference to assess the applicability of our case finding over the rest of NFi. Incidence rates of all PA subgroups except microprolactinomas were statistically equal between these areas; thus, all presented SIRs are based on the NFi's cohort except Oulu University Hospital regional district-based prolactinomas and PAs overall. Overall SIR of PAs was higher (4.0 per 100,000) than in previous reports. Prolactinomas had the highest SIR: 2.2 per 100,000, followed by clinically nonfunctioning PAs (1.0) and GH-secreting (0.34), ACTH-secreting (0.17), and TSH-secreting (0.03) PAs. The gender-specific SIR was 2.2 per 100,000 in males and 5.9 per 100,000 in females. Pituitary apoplexy occurred as a presenting symptom in 11% of clinically nonfunctioning PA patients. The SIR of incidentally discovered PAs increased significantly from 1992-1999 to 2000-2007 (0.59 to 1.6, respectively; P < 0.01), which accounted for the perceived increasing trend in the overall SIR of PAs (3.8 to 4.2; P > 0.05).

Spontaneous pathology of the baboon endocrine system

Study of endocrine pathology in animal models is critical to understanding endocrine pathology in humans. We evaluated 434 endocrine-related diagnoses from 4619 baboon necropsies, established the incidence of spontaneous endocrine pathology, and analyzed the clinical and biochemical data associated with the individual cases. The most common diagnoses in descending order, were pancreatic islet cell amyloidosis (n = 259), ovarian cysts (n = 50), pituitary adenoma (n = 37), pancreatic islet cell adenoma (n = 20), granulosa cell tumor (n = 15), thyroid adenoma (n = 11), adrenal hyperplasia (n = 10), thyroid carcinoma (n = 8), and pheochromocytoma (n = 6). The incidence of pancreatic islet cell amyloidosis progressively increased with age. Pheochromocytomas were associated with renal and heart failure. The incidence of pancreatic islet cell amyloidosis and adrenal pathology was similar to humans; the incidence of pituitary adenoma and thyroid pathology was lower than in humans. Endocrine disease in baboons is common and shares clinical and biochemical characteristics with endocrine disease in humans.

Increased Incidence of Pituitary Microadenomas in Suicide Victims

Background: Current data suggest an influence of the hypothalamic-pituitary-adrenal axis on suicidal behavior. The frequency of pituitary adenomas in suicide victims has not yet been investigated. Objectives: The aim of this study was to assess whether the incidence of pituitary adenomas is correlated with suicide. Methods: Serial sections of 151 human pituitary glands obtained upon autopsy were examined microscopically. The glands were collected from 70 suicide victims and 81 subjects whose deaths were classified as unexpected or accidental (nonsuicidal group). The sections were stained with hematoxylin-eosin and the presence of adenoma was confirmed by immunostaining for collagen III. Results: In the suicidal group, pituitary microadenomas were found in 32 cases (47.7%), while in the nonsuicidal group microadenomas were detected in 15 cases (18.3%). The observed difference was statistically significant (p = 0.0003). The relative risk ratio of suicide in persons with pituitary adenomas was estimated at 1.9. Logistic regression analysis in a model controlled for age and sex showed that microadenomas constituted a unique risk factor in this model. The immunohistochemical phenotyping revealed a higher percentage of immunopositive (secreting) microadenomas in the nonsuicidal group as compared to the suicidal group (80.0 vs. 59.38%) and a predominance of growth hormone-secreting microadenomas in both groups. However, these differences as well as differences in the hormonal profiles of microadenomas between the groups were not significant. Conclusions: These results suggest that pituitary adenomas belong to suicide risk factors.