AI Summary & Key Takeaways
AI InsightThese findings support a thorough hormonal and radiological work-up at diagnosis.
📌 3 Key Takeaways
Abstract
Aims: Large and giant sellar masses are uncommon but clinically important lesions. We aimed to describe the clinical, biochemical, radiological, and histopathological features of patients with a sellar mass ≥30 mm and to examine differences by gender and age. Methods: In this single-centre, retrospective study, we screened 5,142 contrast-enhanced pituitary magnetic resonance imaging reports belonging to 3,414 patients evaluated between December 2021 and December 2024. Patients aged ≥18 years with a sellar mass ≥30 mm in maximum diameter were included. Clinical, biochemical, radiological, and histopathological data were collected and analysed. Results: Seventy-two patients were included (40 male, 32 female; mean age 55.4±14.4 years). The median maximum diameter was 34.0 (30.0-55.0) mm. Optic chiasm compression (81.9%), cavernous sinus invasion (79.2%), and sphenoid sinus invasion (54.2%) were frequent. Half of the patients (50.0%) had at least one anterior pituitary hormone deficiency, and 22.2% had panhypopituitarism. Thirteen tumours (18.1%) were functioning, most often causing acromegaly. Pituitary adenoma was the dominant histopathological diagnosis (90.3%), and gonadotroph adenomas predominated (69.6%). Male had larger tumours than female, by both maximum diameter (38.0 vs 34.0 mm; p=0.007) and volume (14.3 vs 10.5 cm³; p=0.002). Functioning tumours were more common in younger patients (p=0.024), whereas sphenoid sinus invasion was more frequent with advancing age (p=0.002). Conclusion: Large and giant sellar masses are usually invasive, compress the optic chiasm, and are accompanied by hypopituitarism in half. Most are non-functioning gonadotroph adenomas. Male present with larger tumors, and functioning tumors cluster in younger patients. These findings support a thorough hormonal and radiological work-up at diagnosis.