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Clinical outcomes in male patients with lactotroph adenomas who required pituitary surgery: a retrospective single center study

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Abstract

Purpose

Lactotroph adenomas (LA) are the most frequently encountered pituitary tumors. Although more frequently observed in women, LAs in men were recently included in a more aggressive category regardless of histological grading, by the WHO. We aimed to perform a rigorous retrospective review of a single center’s pre-operative evaluation, patient characteristics and outcomes of male LAs patients requiring pituitary surgery.

Methods

A retrospective review, over 11 years, of patients who underwent resection of a pituitary adenoma at a single center was conducted. Predictors of persistent disease in male LAs patients along with a comparison to predictors of silent corticotroph adenomas (SCAs) patients who also underwent surgery at the center was also conducted.

Results

Thirty-one male patients with LAs were identified. When compared to SCAs patients, LAs male patients were younger (41 vs. 50 years of age, p = 0.01). Men with LAs had more invasive tumors (75% vs. 44.7% p = 0.02). More LAs in men had residual tumor after surgery than patients with SCA (92.6% vs. 42.1%, p < 0.001). Male patients with LAs and patients with SCA had similar rates of requiring additional surgery (28.9% vs. 24.1%, p = NS) and radiation therapy (18.4% vs. 19.4%, p = NS).

Conclusions

High rates of DA resistance, invasive tumors and postoperative residual disease in male patients with LA who required surgery are shown. Surgery improved optic chiasm compression, PRL level and central hypogonadism but, not surprisingly, failed to normalize other pituitary hormones and/or eliminate need for DA therapy.

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Acknowledgements

The authors would like to thank Dr. Joao Prola, OHSU neuroradiologist, for assistance in re-reading magnetic resonance images. Dr. Fabienne Langlois, endocrinologist, at OHSU and Centre Hospitalier Universitaire de Sherbrooke, Canada for assistance with manuscript review.

Funding

This study did not receive any specific grant from any funding agency in the public, commercial or non-for-profit sector.

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Author notes

  1. Winnie Liu and Roula Shraiky Zahr have contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, Diabetes & Clinical Nutrition, Oregon Health & Science University, Portland, OR, USA

    Winnie Liu, Roula Shraiky Zahr & Maria Fleseriu

  2. Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA

    Shirley McCartney, Justin S. Cetas, Aclan Dogan & Maria Fleseriu

  3. Northwest Pituitary Center, Oregon Health & Science University, Portland, OR, USA

    Shirley McCartney, Justin S. Cetas, Aclan Dogan & Maria Fleseriu

Authors
  1. Winnie Liu
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  2. Roula Shraiky Zahr
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  4. Justin S. Cetas
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Correspondence to Maria Fleseriu.

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All authors declare no conflict of interest that could prejudice the study reported.

Additional information

Winnie Liu and Roula Shraiky Zahr are first authors.

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Liu, W., Zahr, R.S., McCartney, S. et al. Clinical outcomes in male patients with lactotroph adenomas who required pituitary surgery: a retrospective single center study. Pituitary 21, 454–462 (2018). https://doi.org/10.1007/s11102-018-0898-y

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