Introduction: Sellar region tumors are one of the most common benign intracranial neoplasms. In case of hormonally active adenomas, the typical clinical symptoms help to set the diagnosis. In contrast, in case of non-functioning adenomas, incidental discoveries and compression symptoms dominate.
Patients and methods: We examined the data of 304 patients (184 male and 120 female) who were diagnosed with sellar macroadenomas (with the largest diameter above 10 millimetres) between 1980-2023. Average age at the time of diagnosis was 47.46 years (min-max: 3-79) and the median follow-up was 12.36 years (min-max: 0.5-40). In the study we summarized the typical clinical symptoms, the size of the tumors, the hormonal overproduction, hypopituitarism caused by the tumors, the histopathological reports, the recurrencies, and the therapeutic procedures.
Results: The main symptoms of patients investigated were the following: visual impairment and visual field disturbances, headache, dizziness, sexual disorders, and fatigue. Some of the tumors were discovered incidentally. Based on the sellar MRI scans of the identified tumors, the largest diameter was 27 millimetres (minmax: 10-60). Two hundred seventy-seven patients from the 304 had neurosurgical operations, and preoperative hormonal evaluation was conducted in 170 cases. Among the patients with residual or recurrent tumors, 36 patients had a second, 16 had a third, and 5 had a fourth neurosurgical operation. Thirty patients received postoperative radiation treatment. Out of the 250 histopathological reports available, 121 showed chromophobe adenoma, 38 somatotropinoma, 28 lactotroph adenoma, 22 craniopharyngioma, 11 Ratke’s cyst, 8 mammosomatotropinoma, 7 corticotropinoma, and 15 other types of tumors such as meningioma, metastasis, astrocytoma, etc.
Conclusion: The outcome of our retrospective study shows that patients with pituitary macroadenomas need lifelong regular medical care. During the thorough medical care, the coordinated teamwork of endocrinologists, neurosurgeons, histopathologists, and radiotherapists has a very important role. Both preoperative and postoperative hormonal evaluations as well as imaging procedures are important for early diagnosis and optimal surgical and endocrine care.