[Initial symptoms and anamnestic time in 517 patients with pituitary adenoma].

OBJECTIVE

To find out whether recent techniques of investigating hypophyseal adenoma (computed tomography, magnetic resonance imaging and hormonal measurements) have brought about earlier diagnosis.

PATIENTS AND METHODS

The time of onset of first symptoms and the duration from first symptoms to diagnosis (anamnestic time) were determined retrospectively from clinical, endocrinological, ophthalmological and localizing data on 517 patients (311 women, 206 men) with hypophyseal adenoma.

RESULTS

The most common initial symptom was oligo- or amenorrhoea, in 57.9% of women, and disturbed libido or potency in 38.5% of men. Next most common were visual field deficits (women: 11.6%, men: 26.7%), signs of acromegaly (women: 11.3%, men 18.2%) and headaches (women: 11.3%, men 15.5%). The median anamnestic time in women, 3.0 years, was significantly longer than the 2.3 years in men (P < 0.001). In hormonally inactive adenoma the corresponding times were 2.0 years in women and 1.0 year in men; in prolactinoma 4.2 years and 2.0 years; in growth-hormone secreting adenoma 5.0 years and 5.5; and in ACTH-secreting adenoma 5.0 years and 1.0 year.

CONCLUSIONS

Although diagnostic techniques have greatly improved, the anamnestic time for hypophyseal adenoma is not shorter than in earlier studies. This findings underlines the need for clearly directed history-taking and for good training in endocrinology.