AI Article Synopsis
- - Surgical decompression is typically recommended for treating nonfunctioning pituitary macroadenomas (NFPMAs) that cause visual impairment and other symptoms, but even asymptomatic patients may face increased health issues if they opt for conservative treatment.
- - A study of 55 patients who were conservatively treated for NFPMAs revealed that many developed new symptoms, including headaches, hypertension, and hypopituitarism, along with higher rates of emergency department visits.
- - The findings indicate that early surgical intervention for NFPMAs could potentially reduce the risk of developing additional health problems and enhance overall well-being for these patients.
Article Abstract
Background: Surgical decompression is the recommended treatment for patients with nonfunctioning pituitary macroadenomas (NFPMAs) with associated visual impairment. Other relative indications for surgery include endocrinopathies, craniopathies, and headaches. Nevertheless, patients without these classical indications who would otherwise be considered asymptomatic with regard to the NFPMA and treated conservatively with clinical radiological surveillance may experience higher rates of other morbidities related to the NFPMA. We aimed to evaluate the prevalence of newly diagnosed comorbidities in conservatively treated patients with NFPMAs.
Methods: We reviewed the medical records of 55 patients with NFPMAs from 2012 to 2022 who lacked classical indications for surgery at diagnosis. During the follow-up period, we searched for any of the following potentially associated newly reported symptoms and signs: headache, dizziness, syncope, gastrointestinal symptoms, hyponatremia, falls, weakness and general deterioration, cerebrovascular accident-related symptoms, and endocrine-related symptoms including type 2 diabetes mellitus. Patients were compared with a matched control group. Cohort patients were further analyzed to detect specific endocrine axis deficiencies, and tumor volumes were measured using magnetic resonance imaging at diagnosis.
Results: The final cohort included 55 patients. NFPMAs were associated with the development of newly diagnosed headaches, hypertension, and hypopituitarism. Other symptoms associated with NFPMAs included dizziness, syncope/presyncope, gastrointestinal-related symptoms, hyponatremia, general weakness and falls, and infection-related symptoms. Average associated emergency department visits in this group were higher compared with the control group.
Conclusions: These results may suggest the advantages of early surgical intervention for NFPMAs to mitigate comorbidities and improve health-related quality of life.
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| http://dx.doi.org/10.1016/j.wneu.2024.08.151 | DOI Listing |
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