Ann Clin Diabetes Endocrinol | Volume 5, Issue 1 | Research Article | Open Access

Pituitary Incidentalomas: A Tunisian Experience

Hadjkacem F, Ben Bnina M, Trimeche O, Frikha H*, Charfi N, Mnif M, Mnif F, Ben Salah D, Mejdoub Rekik N, Elleuch M and Abid M

Department of Endocrinology, Hedi Chaker Universitary Hospital, University of Sfax, Tunisia

*Correspondance to: Frikha H 

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Background: Pituitary Incidentalomas (PI) are pituitary lesions that are unexpectedly discovered on brain imaging conducted in order to explore symptoms un-suggestive of a pituitary disease. The aim of our study is to describe the clinical, biochemical and radiological characteristics of PI and to detail the therapeutic and evolutive modalities. Methods: This is a descriptive retrospective study conducted at the Endocrinology-Diabetology Department of the Hedi Chaker University Hospital in Sfax-Tunisia, after collecting medical records of 12 patients with PIs between January 2000 and December 2020. We included patients with PI who underwent adequate biochemical evaluation and we excluded patients who were not explored. Results: We collected the data of 12 adult patients (8 men and 4 women). The mean age of our study group was 46.2 years [18 to 75 years]. The diagnosis of PI was established following a brain MRI in 8 patients and CT scan in 4 cases, of which 3 had then MRI. All PIs in our series were pituitary adenomas. Radiological and biochemical investigations concluded that nine of our patients had non-functional pituitary adenomas including 2 microadenomas while the remaining three were prolactinomas. Headache was the most common revealing circumstance of PI, found in 5 cases. In our study, three of our patients reported sexual complaints. Clinical hypothyroidism without goiter was found in 4 patients while one patient presented thyrotoxicosis with two palpable thyroid nodules. The clinical examination revealed no acromegalic nor cushingoid features in all patients. Hormonal assessment confirmed a gonadotropic and corticotropic insufficiency in three male patients. As for serum prolactin, it was elevated in four patients. Visual acuity assessment was reported in only 10 patients. It was normal in 2 patients, while 8 patients had a decreased Visual Acuity (VA). Prolactinoma were treated with an average dose of 3 mg per day of bromocriptine. Post-surgical complications were noted in 3 cases. Gonadotropic was the most common complication found in all three cases while corticotropic and thyrotrophic insufficiency and diabetes insipidus were noted in one case. Our series included one case of post-operative purulent meningitis. Conclusion: Pi is a frequent finding that should be taking seriously since it can be a life-threatening tumor and therefore a careful clinical examination, hormonal, radiological, ophthalmological assessment is crucial in order to dictate the appropriate management of the lesion.


Thyrotoxicosis; Hypothyroidism; Hyperthyroidism; Diabetes insipidus


Hadjkacem F, Ben Bnina M, Trimeche O, Frikha H, Charfi N, Mnif M, et al. Pituitary Incidentalomas: A Tunisian Experience. Ann Clin Diabetes Endocrinol. 2022; 5(1): 1025.

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