Clinical Characteristics, Chief Complaints, and MRI Imaging Features of Pituitary Macroadenomas at Dr. Saiful Anwar General Hospital
Clinical Characteristics, Chief Complaints, and MRI Imaging Features of Pituitary Macroadenomas at Dr. Saiful Anwar General Hospital
DOI:
https://doi.org/10.11594/jk-risk.05.1.3Keywords:
Pituitari, Makroadenoma, MRIAbstract
ntroduction: Pituitary macroadenomas are benign neoplasms of the pituitary gland that often cause significant mass effects, such as compression of the optic chiasm and cavernous sinus, as well as hormonal disturbances. Studies on the demographic characteristics, chief complaints, and imaging features of pituitary macroadenomas in Indonesia remain limited. This study aims to provide a comprehensive overview of patients with pituitary macroadenomas at Saiful Anwar General Hospital.
Objective: This study aims to analyze the demographic distribution, clinical complaints, and MRI imaging characteristics of patients with pituitary macroadenomas.
Methods: This retrospective descriptive study involved 23 patients who underwent brain MRI at Saiful Anwar General Hospital between January 2020 and December 2024. Demographic data, chief complaints, and MRI imaging findings were analyzed descriptively. Variables evaluated included age, gender, chief complaints, tumor consistency, and signal intensity on T1- and T2-weighted sequences.
Results: Among the 23 patients, 82.6% were female, with a mean age of 46.95 years. The most frequently reported complaint was blurred vision (43.5%), caused by optic chiasm compression. Most tumors were solid (69.6%), with hyperintensity dominance on T2-weighted sequences (78.3%). Suprasellar extension was observed in most patients, involving the optic chiasm and cavernous sinus.
Conclusion: Pituitary macroadenomas are more commonly found in middle-aged females, with visual disturbances being the dominant complaint. MRI revealed solid consistency with signal heterogeneity, emphasizing the importance of radiological evaluation for early diagnosis and therapeutic planning. A multidisciplinary approach is essential to improve patient quality of life.
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References
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24. Tran L, Papasavvas I, Herbort C. Pituitary Macroadenoma: Fooling the Ophthalmologist before Giving Him the Role of the Whistle-Blower. Klinische Monatsblatter fur Augenheilkunde 2022;239 4:468–75.
25. Siddiqui MYA, Mohammed A, Fatih MA, Masoodi N, Elzouki AN. Benign tumor mimicking malignancy: Atypical presentation of hemorrhagic macroadenoma. Libyan Journal of Medical Sciences 2020;4:84–6.
26. Alashwah MA, Moharram M, Allakany A. Role of diffusion weighted magnetic resonance imaging DW-MRI in choice of the surgical approach for pituitary macroadenoma resection. The Egyptian Journal of Radiology and Nuclear medicine 2017;48:983–9.
27. Lee IH, Zan E, Bell WR, Burger PC, Sung H, Yousem DM. Craniopharyngiomas : Radiological Differentiation of Two Types. J Korean Neurosurg Soc 2016;59(5):466–70.
28. Husni H, Hamrahian AH. Dural tail sign in meningiomas. AACE Clinical Case Reports 2021;7(3):226–7.
29. Sitanggang FP, Ayusta IMDP, Suastari NMP. Peran MRI dalam pencitraan diagnostik tumor cerebellopontine angle (CPA). Baswara Press; 2021.
30. Aydin S, Darko K, Detchou D, Barrie U. Rathke’s cleft cysts: from pathophysiology to management. Neurosurgical Review 2024;47(1):522.
31. Allaw S, Khabaz K, Given TC, Montas DM, Alcazar-Felix RJ, Srinath A, et al. A review of intracranial aneurysm imaging modalities, from CT to state-of-the-art MR. American Journal of Neuroradiology 2024;
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33. Lelotte J, Mourin A, Fomekong E, Michotte A, Raftopoulos C, Maiter D. Both invasiveness and proliferation criteria predict recurrence of non-functioning pituitary macroadenomas after surgery: a retrospective analysis of a monocentric cohort of 120 patients. European journal of endocrinology 2017;178 3:237–46.
2. Molitch M. Diagnosis and Treatment of Pituitary Adenomas: A Review. JAMA 2017;317:516.
3. Mehta G, Lonser R. Management of hormone-secreting pituitary adenomas. Neuro-Oncology 2016;19:762.
4. Chin S. Epidemiology of Functioning Pituitary Adenomas. Endocrinology and Metabolism 2020;35:237–42.
5. Melmed S, Kaiser U, Lopes M, Bertherat J, Syro L, Raverot G, et al. Clinical Biology of the Pituitary Adenoma. Endocrine Reviews 2022;43:1003–37.
6. Ntali G, Wass J. Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas. Pituitary 2018;21:111–8.
7. Gillett D, MacFarlane J, Bashari W, Crawford R, Harper I, Mendichovszky I, et al. Molecular Imaging of Pituitary Tumors. Seminars in nuclear medicine [Internet] 2023;Available from: https://consensus.app/papers/molecular-imaging-of-pituitary-tumors-gillett-macfarlane/fdfd0e6dd64c530d96a1f0b41f731a58/
8. Bashari W, Senanayake R, Fernández-Pombo A, Gillett D, Koulouri O, Powlson A, et al. Modern imaging of pituitary adenomas. Best practice & research Clinical endocrinology & metabolism [Internet] 2019;Available from: https://consensus.app/papers/modern-imaging-of-pituitary-adenomas-bashari-senanayake/6b012a160a39564692e1cfea0485f559/
9. Gupta K, Sahni S, Saggar K, Vashisht G. Evaluation of clinical and magnetic resonance imaging profile of pituitary macroadenoma: A prospective study. Journal of natural science, biology, and medicine 2018;9(1):34.
10. Chen W. Host innate immune responses to Acinetobacter baumannii infection. Frontiers in Cellular and Infection Microbiology 2020;10:486.
11. Boertien T, Booij J, Majoie C, Drent M, Pereira A, Biermasz N, et al. 68Ga-DOTATATE PET imaging in clinically non-functioning pituitary macroadenomas. European Journal of Hybrid Imaging [Internet] 2020;4. Available from: https://consensus.app/papers/68gadotatate-pet-imaging-in-clinically-nonfunctioning-boertien-booij/49987fe9f8f759dd9ea7d1f4a92b5670/
12. Tresoldi A, Carosi G, Betella N, Del Sindaco G, Indirli R, Ferrante E, et al. Clinically Nonfunctioning Pituitary Incidentalomas: Characteristics and Natural History. Neuroendocrinology 2019;110:595–603.
13. Najmaldin A, Malek M, Madani NH, Ghorbani M, Akbari H, Khajavi A, et al. Non-functioning pituitary macroadenoma: surgical outcomes, tumor regrowth, and alterations in pituitary function—3-year experience from the Iranian Pituitary Tumor Registry. Hormones 2019;18:197–205.
14. Chen J, Wan Q, Zhu H, Ge Y, Wu L, Zhai J, et al. [The value of conventional magnetic resonance imaging based radiomic model in predicting the texture of pituitary macroadenoma]. Zhonghua yi xue za zhi 2020;100 45:3626–31.
15. Hassan R, Almalki Y, Basha M, Alduraibi S, Hassan AH, Aboualkheir M, et al. Predicting the Consistency of Pituitary Macroadenomas: The Utility of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Measurements for Surgical Planning. Diagnostics [Internet] 2024;14. Available from: https://consensus.app/papers/predicting-the-consistency-of-pituitary-macroadenomas-hassan-almalki/10d80b6e09905b2f89b0359ec8331228/
16. Romano A, Coppola V, Lombardi M, Lavorato L, Di Stefano D, Caroli E, et al. Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency. Pituitary 2016;20:201–9.
17. Bauman C, Milligan J, Labreche T, Riva J. Nonfunctioning pituitary macroadenoma: a case report from the patient perspective. Chiropractic & Manual Therapies [Internet] 2016;24. Available from: https://consensus.app/papers/nonfunctioning-pituitary-macroadenoma-a-case-report-from-bauman-milligan/48a903a2618e5343b755edadeaf3314e/
18. Krivosheeva Y, Ilovayskaya I. Primary signs of pituitary macroadenomas of diff erent hormonal activity and specialists to whom patients referred at the fi rst time. Medical Herald of the South of Russia [Internet] 2022;Available from: https://consensus.app/papers/primary-signs-of-pituitary-macroadenomas-of-diff-erent-krivosheeva-ilovayskaya/47d18a452cdc5775b39b3439476c4d43/
19. Jang M, Oh E, Lee H, Kim E, Kim S. Postoperative Symptoms and Quality of Life in Pituitary Macroadenomas Patients. Journal of Neuroscience Nursing [Internet] 2019;Available from: https://consensus.app/papers/postoperative-symptoms-and-quality-of-life-in-pituitary-jang-oh/f40ecacc12de529296c8ee11adab6bc0/
20. Shah D, Sen J. Pituitary Macroadenoma: A Comprehensive Case Study of Surgical Intervention and Postoperative Management. Cureus [Internet] 2024;16. Available from: https://consensus.app/papers/pituitary-macroadenoma-a-comprehensive-case-study-of-shah-sen/2ae4b12180c5524b8cb099e118aba06b/
21. Di Somma C, Scarano E, de Alteriis G, Barrea L, Riccio E, Arianna R, et al. Is there any gender difference in epidemiology, clinical presentation and co-morbidities of non-functioning pituitary adenomas? A prospective survey of a National Referral Center and review of the literature. Journal of Endocrinological Investigation 2021;44:957–68.
22. Rosinha P, Fonseca L, Amaral C, Ribeiro I, Cardoso M. Pituitary adenomas in the elderly: Retrospective comparative analysis of clinical/tumor features and surgical data by age group. Medicine [Internet] 2022;101. Available from: https://consensus.app/papers/pituitary-adenomas-in-the-elderly-retrospective-rosinha-fonseca/3fc997dfde8c584f87d69c24e67fd6de/
23. Zhao Y, Lian W, Xing B, Wang R. The characteristics of and surgical treatment for pituitary adenomas in patients under 14 years old. Clinical neurology and neurosurgery 2019;184:105423.
24. Tran L, Papasavvas I, Herbort C. Pituitary Macroadenoma: Fooling the Ophthalmologist before Giving Him the Role of the Whistle-Blower. Klinische Monatsblatter fur Augenheilkunde 2022;239 4:468–75.
25. Siddiqui MYA, Mohammed A, Fatih MA, Masoodi N, Elzouki AN. Benign tumor mimicking malignancy: Atypical presentation of hemorrhagic macroadenoma. Libyan Journal of Medical Sciences 2020;4:84–6.
26. Alashwah MA, Moharram M, Allakany A. Role of diffusion weighted magnetic resonance imaging DW-MRI in choice of the surgical approach for pituitary macroadenoma resection. The Egyptian Journal of Radiology and Nuclear medicine 2017;48:983–9.
27. Lee IH, Zan E, Bell WR, Burger PC, Sung H, Yousem DM. Craniopharyngiomas : Radiological Differentiation of Two Types. J Korean Neurosurg Soc 2016;59(5):466–70.
28. Husni H, Hamrahian AH. Dural tail sign in meningiomas. AACE Clinical Case Reports 2021;7(3):226–7.
29. Sitanggang FP, Ayusta IMDP, Suastari NMP. Peran MRI dalam pencitraan diagnostik tumor cerebellopontine angle (CPA). Baswara Press; 2021.
30. Aydin S, Darko K, Detchou D, Barrie U. Rathke’s cleft cysts: from pathophysiology to management. Neurosurgical Review 2024;47(1):522.
31. Allaw S, Khabaz K, Given TC, Montas DM, Alcazar-Felix RJ, Srinath A, et al. A review of intracranial aneurysm imaging modalities, from CT to state-of-the-art MR. American Journal of Neuroradiology 2024;
32. Constantinescu S, Duprez T, Fomekong E, Raftopoulos C, Alexopoulou O, Maiter D. Natural history and surgical outcome of incidentally discovered clinically nonfunctioning pituitary macroadenomas. Endocrine Connections [Internet] 2023;12. Available from: https://consensus.app/papers/natural-history-and-surgical-outcome-of-incidentally-constantinescu-duprez/6d07fba141b2523f99b2468f02e20fb4/
33. Lelotte J, Mourin A, Fomekong E, Michotte A, Raftopoulos C, Maiter D. Both invasiveness and proliferation criteria predict recurrence of non-functioning pituitary macroadenomas after surgery: a retrospective analysis of a monocentric cohort of 120 patients. European journal of endocrinology 2017;178 3:237–46.
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How to Cite
Saputra, A., & Normahayu, I. . (2025). Clinical Characteristics, Chief Complaints, and MRI Imaging Features of Pituitary Macroadenomas at Dr. Saiful Anwar General Hospital: Clinical Characteristics, Chief Complaints, and MRI Imaging Features of Pituitary Macroadenomas at Dr. Saiful Anwar General Hospital. Jurnal Klinik Dan Riset Kesehatan, 5(1), 15-25. https://doi.org/10.11594/jk-risk.05.1.3
