Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study

Introduction: Pituitary tumours are common intracranial tumours affecting mainly the 4th to 7th decade of life. A detailed understanding of these pituitary tumour patients, especially regarding their clinical and MRI profile would help in its early detection.It also help in deciding upon further...

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Main Authors: Shaju Mathew, Geo Paul K Jose, Paruvakkattil Kunjan Balakrishnan, Ebitha K Elias
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2021-10-01
Series:International Journal of Anatomy Radiology and Surgery
Subjects:
Online Access:http://www.ijars.net/articles/PDF/2703/48451_CE[Ra1]_F(SHU)%20GC(AnK)_PF1(MG_SHU)_PFA(MG_KM)_PN(KM).pdf
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author Shaju Mathew
Geo Paul K Jose
Paruvakkattil Kunjan Balakrishnan
Ebitha K Elias
author_facet Shaju Mathew
Geo Paul K Jose
Paruvakkattil Kunjan Balakrishnan
Ebitha K Elias
author_sort Shaju Mathew
collection DOAJ
description Introduction: Pituitary tumours are common intracranial tumours affecting mainly the 4th to 7th decade of life. A detailed understanding of these pituitary tumour patients, especially regarding their clinical and MRI profile would help in its early detection.It also help in deciding upon further management (medical or surgical or radiation), thus helping in improved outcome. Aim: To find out the common clinical presentations and the MRI findings of pituitary tumour. Materials and Methods: A cross-sectional observational study was carried out among 88 patients admitted with diagnosis of pituitary tumour in a tertiary care center from 1st June 2018 to 30th September 2019. The study involved initial clinical assessment followed by MRI brain of all the patients included in the study. To find out relationship between imaging findings and clinical symptoms statistical analysis was done. Results: The most common clinical presentations were headache in 55 patients (commonly throbbing type in frontal region) and visual field defects in 52 patients (uni/bitemporal hemianopia). A 51 (58%) patients had suprasellar extension and 35 (39.8%) patients had tumour already progressed to parasellar extension stage at time of detection of adenoma. Most of the patients detected with pituitary tumours (i.e., 63.6%) had grade two invasion. Four incidental adenomas were detected and none of them had parasellar extension. Among 35 patients with parasellar extension, 27 (77.1%) patients had visual disturbance. In 45 (51.1%) patients without parasellar extension had no sellar floor involvement. Visual disturbance was significantly associated with the parasellar extension of the tumour. Conclusion: Headache and visual field defects were the most common clinical presentation among pituitary tumour patients. Patients with tumours having parasellar extension are more likely to have visual disturbance than with patients having only suprasellar extension. Radiologically, pituitary tumours tend to expand only into suprasellar area, then it involves the parasellar area, followed by sellar floor which occurred last.
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spelling doaj.art-64aa0e4ec8b44f049bc8f667d1cabb582022-12-21T19:40:07ZengJCDR Research and Publications Pvt. Ltd.International Journal of Anatomy Radiology and Surgery2277-85432455-68742021-10-011004111410.7860/IJARS/2021/48451:2703Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational StudyShaju Mathew0Geo Paul K Jose1Paruvakkattil Kunjan Balakrishnan2Ebitha K Elias3Associate Professor, Department of Neurosurgery, Government Medical College, Kottayam, Kerala, India.Senior Resident, Department of Neurosurgery, Government Medical College, Kottayam, Kerala, IndiaProfessor and Head, Department of Neurosurgery, Government Medical College, Kottayam, Kerala, IndiaSenior Resident, Department of Ophthalmology, Government Medical College, Kottayam, Kerala, India.Introduction: Pituitary tumours are common intracranial tumours affecting mainly the 4th to 7th decade of life. A detailed understanding of these pituitary tumour patients, especially regarding their clinical and MRI profile would help in its early detection.It also help in deciding upon further management (medical or surgical or radiation), thus helping in improved outcome. Aim: To find out the common clinical presentations and the MRI findings of pituitary tumour. Materials and Methods: A cross-sectional observational study was carried out among 88 patients admitted with diagnosis of pituitary tumour in a tertiary care center from 1st June 2018 to 30th September 2019. The study involved initial clinical assessment followed by MRI brain of all the patients included in the study. To find out relationship between imaging findings and clinical symptoms statistical analysis was done. Results: The most common clinical presentations were headache in 55 patients (commonly throbbing type in frontal region) and visual field defects in 52 patients (uni/bitemporal hemianopia). A 51 (58%) patients had suprasellar extension and 35 (39.8%) patients had tumour already progressed to parasellar extension stage at time of detection of adenoma. Most of the patients detected with pituitary tumours (i.e., 63.6%) had grade two invasion. Four incidental adenomas were detected and none of them had parasellar extension. Among 35 patients with parasellar extension, 27 (77.1%) patients had visual disturbance. In 45 (51.1%) patients without parasellar extension had no sellar floor involvement. Visual disturbance was significantly associated with the parasellar extension of the tumour. Conclusion: Headache and visual field defects were the most common clinical presentation among pituitary tumour patients. Patients with tumours having parasellar extension are more likely to have visual disturbance than with patients having only suprasellar extension. Radiologically, pituitary tumours tend to expand only into suprasellar area, then it involves the parasellar area, followed by sellar floor which occurred last.http://www.ijars.net/articles/PDF/2703/48451_CE[Ra1]_F(SHU)%20GC(AnK)_PF1(MG_SHU)_PFA(MG_KM)_PN(KM).pdfheadacheparasellarsuprasellarvisual field defect
spellingShingle Shaju Mathew
Geo Paul K Jose
Paruvakkattil Kunjan Balakrishnan
Ebitha K Elias
Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
International Journal of Anatomy Radiology and Surgery
headache
parasellar
suprasellar
visual field defect
title Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
title_full Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
title_fullStr Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
title_full_unstemmed Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
title_short Clinical Presentation of Patients with Pituitary Tumour and its Correlation to Magnetic Resonance Imaging: An Observational Study
title_sort clinical presentation of patients with pituitary tumour and its correlation to magnetic resonance imaging an observational study
topic headache
parasellar
suprasellar
visual field defect
url http://www.ijars.net/articles/PDF/2703/48451_CE[Ra1]_F(SHU)%20GC(AnK)_PF1(MG_SHU)_PFA(MG_KM)_PN(KM).pdf
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