Costachescu Mihai, Nistor Claudiu, Valea Ana, Sima Oana-Claudia, Ciuche Adrian, Stanciu Mihaela, Carsote Mara, Ciobica Mihai-Lucian
Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania.
PhD Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 010825 Bucharest, Romania.
Diseases. 2024 Oct 2;12(10):240. doi: 10.3390/diseases12100240.
Incidentalomas have an increasing incidence all over the world due to a larger access to imaging assessments, and endocrine incidentalomas make no exception in this matter, including pituitary incidentalomas (PIs). Our objective was to analyse the dynamic changes amid a second computed tomography (CT) scan after adult patients were initially confirmed with a PI (non-functioning micro-adenoma). This was a multi-centric, longitudinal, retrospective study in adults (aged between 20 and 70 y) amid real-world data collection. We excluded patients who experienced baseline pituitary hormonal excess or deficiency or those with tumours larger than 1 cm. A total of 117 adults were included (94.02% females) with a mean age of 43.86 ± 11.99 years, followed between 6 and 156 months with a median (M) of 40 months (Q1 Q3: 13.50, 72.00). At the time of PI diagnosis, the transverse diameter had a mean value of 0.53 ± 0.16 cm, the longitudinal mean diameter was 0.41 ± 0.13 cm, and the largest diameter was 0.55 ± 0.16 cm. No PI became functioning during follow-up, neither associated hypopituitarism nor increased >1 cm diameter. A total of 46/117 (39.32%) patients had a larger diameter during follow-up (increase group = IG) versus a non-increase group (non-IG; N = 71, 60.68%) that included the subjects with stationary or decreased diameters. IG had lower initial transverse, longitudinal, and largest diameter versus non-IG: 0.45 ± 0.12 versus 0.57 ± 0.17 ( < 0.0001), 0.36 ± 0.11 versus 0.43 ± 0.13 ( = 0.004), respectively, 0.46 ± 0.12 versus 0.6 ± 0.16 ( < 0.0001). IG versus non-IG had a larger period of surveillance: M (Q1, Q3) of 48 (24, 84) versus 32.5 (12, 72) months ( = 0.045) and showed similar age, pituitary hormone profile, and tumour lateralisation at baseline and displayed a median diameter change of +0.14 cm versus -0.03 cm ( < 0.0001). , a rather high percent of patients might experience PI diameter increase during a longer period of follow-up, including those with a smaller initial size, while the age at diagnosis does not predict the tumour growth. This might help practitioners with further long-term surveillance protocols.
由于影像学检查的可及性提高,偶发瘤在全球的发病率不断上升,内分泌偶发瘤也不例外,包括垂体偶发瘤(PI)。我们的目的是分析成年患者最初确诊为PI(无功能微腺瘤)后,在第二次计算机断层扫描(CT)期间的动态变化。这是一项多中心、纵向、回顾性研究,纳入了成人(年龄在20至70岁之间)的真实世界数据。我们排除了有基线垂体激素过多或缺乏的患者,以及肿瘤大于1厘米的患者。共纳入117名成年人(94.02%为女性),平均年龄为43.86±11.99岁,随访时间为6至156个月,中位数(M)为40个月(四分位间距:13.50,72.00)。在PI诊断时,横径的平均值为0.53±0.16厘米,纵径平均值为0.41±0.13厘米,最大直径为0.55±0.16厘米。随访期间没有PI转变为功能性肿瘤,也没有出现垂体功能减退或直径增加>1厘米的情况。共有46/117(39.32%)的患者在随访期间直径增大(增大组=IG),而未增大组(非IG组;N=71,60.68%)包括直径稳定或减小的受试者。IG组的初始横径、纵径和最大直径均低于非IG组:分别为0.45±0.12与0.57±0.17(P<0.0001),0.36±0.11与0.43±0.13(P=0.004),0.46±0.12与0.6±0.16(P<0.0001)。IG组与非IG组相比,监测时间更长:中位数(四分位间距)为48(24,84)个月与32.5(12,72)个月(P=0.045),且在基线时年龄、垂体激素谱和肿瘤定位相似,直径变化中位数分别为+0.14厘米与-0.03厘米(P<0.0001)。相当高比例的患者在较长时间的随访中可能会出现PI直径增大,包括初始尺寸较小的患者,而诊断时的年龄并不能预测肿瘤生长。这可能有助于医生制定进一步的长期监测方案。