Page 1 of 7
European Journal of Business &
Social Sciences
Available at https://ejbss.org/
ISSN: 2235-767X
Volume 07 Issue 05
May 2019
Available online:https://ejbss.org/ P a g e | 1634
"Clinical, hormonal, neuroimaging characteristics of patients with
inactive adenomas and incidentalomas of the pituitary gland"
Khalimova Z.Yu., Azimov G.V.
Tashkent Pediatric Medical Institute, Department of Endocrinology with Pediatric
Endocrinology, Republican Specialized Scientific and Practical Medical Center of
Endocrinology of the Republic of Uzbekistan named after acad. Y.H. Turakulova, Department of
Neuroendocrinology with Pituitary Surgery
Tashkent, 100125, St. Mirzo Ulugbek 56, Tel / fax: + 099871-2622702.
Relevance. Pituitary adenoma (PA) is a tumor of the endocrine system, the
manifestation of which is the hyper- or hypo-secretion of hormones of the anterior
pituitary gland, as well as the clinical symptoms caused by the effect of the
neoplasm on the surrounding anterior region of the anterior structure [1-5].
The insidiousness of the disease lies in the fact that it occurs without visible
clinical manifestations, impaired secretion of pituitary hormones, which
determined to call them non-functional pituitary adenomas (NFPA). Therefore, the
acute problem of early diagnosis of the disease [11-13]
It is enough to note that more than 25-30% of patients with NFPA become
disabled and the cost of their treatment according to WHO (2004) in the
economically developed countries of the world is from 24 to 40 billion US dollars.
All this determines not only a medical, but also a socio-economic problem [6-7].
It is necessary to distinguish between the concepts of NFPA and
<incidentalomas of the pituitary gland> (IP), the latter is often found in foreign
literature. Incidentalomas (incidentally) - tumor formations that are detected in any
organ by chance with a more detailed examination of the patient.
Pituitary incidentalomas can be both NFPA and hormonally active adenomas,
for example, prolactinomas. Since the typical clinical signs for this type of tumor
are absent, as a rule, there is a late diagnosis of NFPA at the stage of visual and
neurological disorders, hypopituitarism, which leads to disability of patients. In
this regard, the identification of the first symptoms of NFPA is one of the urgent
problems for both endocrinologists and neurosurgeons. [8-9].
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European Journal of Business &
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Available at https://ejbss.org/
ISSN: 2235-767X
Volume 07 Issue 05
May 2019
Available online:https://ejbss.org/ P a g e | 1635
However, there is still no single view on the features of NFPA and IG,
which was the reason for this study.
All of the above was the reason for conducting the present study.
The purpose of the study is to study the clinical, hormonal and neuroimaging
characteristics of patients with NAG and IG
Material and methods of research. For the period from 2016 to 2018 235
patients with NAG and IG were examined, according to the analysis of MRI / CT
in Tashkent. Among them, men - 122 (51.9%), women - 113 (48.0%). Middle age:
men were 37.12 years old, women - 38, 15 years old. Disease duration ranged from
2 months to 15 years.
Research methods included: 1) general clinical 2) instrumental (perimetry
for all colors, fundus of the eye, visual acuity, ECG, CT / MRI (computed
tomography / magnetic resonance imaging) of the Turkish saddle and adrenal
glands, etc.), 3) hormonal blood tests (STH, IGF-1, LH, FSH, prolactin, TSH,
ACTH, free testosterone, estradiol, cortical, free thyroxin), 4) biochemical blood
tests (LDL, HDL, cholesterol, triglycerides, calcium, chlorides, sodium and
others).
The obtained data were processed using computer programs Microsoft Excel
and STATISTICA_6. Differences between groups were considered statistically
significant at P< 0.05. The mean values (M), standard deviations of the mean (m)
were calculated.
The significance of differences in the level between groups was assessed by
the magnitude of the confidence interval and student's criterion (p). Differences
were considered statistically significant at p <0.05.
The results of the study. Table 1 shows the distribution of patients by sex
and age. The patients were divided into 2 groups: 1 group - NAG - 115 patients, 2
group - IG-120 patients.
Page 3 of 7
European Journal of Business &
Social Sciences
Available at https://ejbss.org/
ISSN: 2235-767X
Volume 07 Issue 05
May 2019
Available online:https://ejbss.org/ P a g e | 1636
Table 1. The distribution of patients by sex and age
The age , years The number of men The number of women
1 gr 2 gr 1 gr 2 gr
16 – 29 13 18 16 12
30-44 25 24 21 23
45-59 10 12 7 8
60-74 10 10 11 12
75 and more - - 2 1
Total : n = 235 58 64 57 56
CT and MRI of the Turkish saddle allowed us to detect hypothesis (PA)
adenomas of various sizes in our patients: from micro (up to 10 mm) to massive
AH (> 30 mm) by X-ray radiological classification I.I. Grandfathers (1997) as
follows:
one). Micro adenomas - (interstellar, d <10 mm) - 95 patients with NFPA
and 115 with IP;
2) Macro adenomas - with suprasellar growth:
a) group A (suprasellar growth within 10 mm above the pituitary fossa) - 4/0
bx;
b) group B (suprasellar growth within 20 mm, AG raises the anterior pocket
of the Sh ventricle) - large PA - 3/0 b-x;
c) group C (suprasellar growth up to 30 mm, fills the anterior part of the
third ventricle). Very large PA - 5/0 cases;
d) group D (suprasellar growth> 30 mm, rise above the level of the Monroe
hole, or adenomas of group C with asymmetrical lateral or multiple growth)
- Massive PA - 8/0
The most frequent complaints in patients with NFPA were: headaches - 45
patients (39.1%), memory loss - 17 patients (14.7%), astheno-depressive
syndrome - 17 (14.7%), secondary amenorrhea - 15 patients from 57 women
(26.3%), reduced vision - 12 (10.4%), bitemporal hemianopsia-10 (8.6%),
etc.
In patients with IP complaints was not.
Table 2 presents frequency various neuroendocrine disorders in the
examined patients. It was found that in 1 group of patients most frequently
met Hypopituitarism-u 38 of 115 patients (33.0%), while group 2
pangipopituitarizma were observed. Bitemporal hemianopsia could also be
