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SAN ANTONIO -- One in five adults has a pituitary tumor, according to a metaanalysis of nine carefully designed autopsy and radiographic studies.
"About one-third of these [tumors] may result in pituitary excess syndromes," with symptoms including irregular menses, sexual dysfunction, infertility, changes in physical appearance, headaches, visual field disturbances, and unexplained mood changes, said Dr. Keith E. Friend, the principal investigator in the study.
The analysis also suggests that macroadenomas, defined as pituitary tumors greater than 10 mm in diameter, are present m approximately 1 in 500-600 adults over the age of 65. That figure is at least 10 times greater than the number of patients diagnosed with these large tumors, which commonly invade brain structures surrounding the pituitary gland.
"Perhaps we are all missing these patients," said Dr. Friend, who presented his findings at a satellite seminar held at the annual meeting of the American Association of Clinical Endocrinologists. He conducted the research while at the University of Texas M.D. Anderson Cancer Center in Houston; he is now medical director of U.S. adult endocrine care at Pharmacia Corp. in Peapack, N.J.
Dr. Friend asked researchers from the University of Toronto; New York University, New York; and the University of Texas M.D. Anderson Cancer Center to individually review published prevalence studies on pituitary tumors.
Published estimates range from 10%, based on an epidemiologic study, to less than 1% and more than 30%, based on radiologic studies of adults who underwent imaging for reasons other than symptoms of pituitary tumors. In autopsy studies done on patients who died of causes unrelated to pituitary tumors, the tumors have been found in as few as 1.4% and as many as 27% of adults.
For many reasons, pituitary tumor prevalence is difficult to study, Dr. Friend said. Pituitary tumors tend to be small, and they manifest a puzzling array of symptoms, many of them subtle. These tumors are difficult to image, and biochemical diagnoses are "not always straightforward," he said.
Source: HighBeam Research, Pituitary Tumors In 20% of Adults.