Introduction: Functioning pituitary adenomas are usually benign, slow-growing lesions, that lead to diseases of excessive hormone secretion. Most of their signs and symptoms are unspecific at the beginning and overlap with those of other, more common disorders, making diagnosis at presentation challenging. The consequences of delayed diagnosis are a variety of complications, reduced quality of life and increased risk of mortality. We aim to evaluate the characteristics associated to delayed diagnosis of functioning pituitary adenomas.
Methods: Charts of 72 patients, surgically treated for a functioning pituitary adenomas, were reviewed. Data regarding patients age, sex, hormonal profile, symptoms history, tumor size, MRI characteristics, surgical records and immunohistochemical study was collected.
Results: The mean time from onset of symptoms to diagnosis was 4 years and three months. Growth hormone secreting tumors were the lesions most associated with diagnosis delay, with an average of eight years of symptoms before tumor detection. There was a positive correlation between tumor size and a longer time of diagnosis delay, but no influence of patients sex on diagnosis time. Elderly patients were more likely to have late diagnosis.
Conclusions: Functioning pituitary adenomas initially present in non-specific ways and usually are not considered part of an overall syndrome. GH secreting tumors and patients age seem to be the factors most associated to delay in diagnosis. Larger tumors were strongly associated to a longer history of symptoms. Delayed diagnosis is associated to higher morbidity levels.
Patient Care: By presenting this study, we expect to highlight factors associated to diagnosis delay of functioning adenomas and help to improve patient care.
Learning Objectives: Discuss factors associated to delay in diagnosis of functioning adenomas.