Mortality / Morbidity 009

 Mortality / Morbidity 009

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Mortality rate related to pituitary tumors is low. Advances in medical and surgical management of these lesions and the availability of hormonal replacement therapies have contributed to successful management.  Pituitary apoplexy can be a lethal complication.   Morbidity associated with macroadenomas may include permanent visual loss, ophthalmoplegia, and other neurological complications.  Tumor recurrence is also a possibility.  CNS metastases and, rarely, distant metastases occur with pituitary tumors.  Endocrine abnormalities are amenable to correction. However, damage in many organ systems as a result of long-standing uncorrected deficiencies may be irreversible⁽⁵⁰⁾.

Race

No racial predilection is known .

Sex

Symptomatic prolactinomas are found more frequently in women. Cushing disease also Is ,more frequent in women (female-to-male ratio 3:1).

Age

Most pituitary tumors occur in young adults , but they may be seen in abolescents and elderly persons . Acromegaly usually is seen in the fourth and fifth decades of life .

Clinical history

The presentation of a pituitary macroadenoma relates to its mass effect and pressure on surrounding structures.  Fifty to sixty percent present with visual symptoms due to compression of optic nerve structures. Nonspecific headache can be seen.  Lateral extension can result in compression of the cavernous sinuses and may cause ophthalmoplegia, diplopia, and/or ptosis. Talkad et al recently reported an isolated, painful, postganglionic Horner syndrome as the initial sign of lateral extension of a large prolactinoma⁽⁴⁵⁾. Extension into the sphenoid sinuses can cause spontaneous cerebrospinal fluid (CSF) rhinorrhea.  In addition to visual symptoms, endocrine dysfunction⁽⁴⁹⁾.

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