Document Detail


Clinical predictors of advanced sellar masses.
MedLine Citation:
PMID:  17954416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify clinical variables associated with the presence of a structurally advanced sellar mass (ASM). METHODS: We performed a retrospective study of patients referred for evaluation of suspected new pituitary disease or sellar mass to the Endocrine Oncology Unit of Mount Sinai Hospital in Toronto, Ontario, Canada. By multivariate analysis, we examined predictors of a structurally ASM (a sellar lesion with any of the following characteristics: diameter of >or=1 cm on magnetic resonance imaging [MRI], optic chiasmal compression on MRI, or clinical or biochemical evidence of hypopituitarism). RESULTS: Data from 152 patients were analyzed. Of the 152 sellar masses, 142 (93%) were pituitary adenomas. An ASM was noted in 85 of the 152 patients (56%). In the final multivariate model, male sex (odds ratio [OR], 6.23; 95% confidence interval [CI], 2.84 to 13.56; P<0.001) and self-reported visual field defect (OR, 3.62; 95% CI, 1.07 to 12.25; P = 0.039) were significantly independently associated with the presence of an ASM. The presence of new or changed headaches also tended to be associated with an ASM (OR, 2.11; 95% CI, 0.96 to 4.64; P = 0.063). Age and self-reported galactorrhea were not independently associated with the presence of an ASM and were conditionally removed from the final model. CONCLUSION: In patients with suspected sellar or pituitary disease, male sex and self-reported visual field defects independently predict the presence of an ASM. New or changed headaches also tend to be related to the presence of an ASM. The presence of predictors of an ASM should prompt expedited sellar MRI and biochemical evaluation.
Authors:
Gloria M Rambaldini; Sonia Butalia; Shereen Ezzat; Walter Kucharczyk; Anna M Sawka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  13     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-23     Completed Date:  2008-01-08     Revised Date:  2008-01-15    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-14     Citation Subset:  IM    
Affiliation:
Department of Medicine, York Central Hospital, Richmond Hill, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  diagnosis*
Adult
Confidence Intervals
Diagnosis, Differential
Female
Headache / etiology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Ontario
Pituitary Neoplasms / complications,  diagnosis*
Retrospective Studies
Sella Turcica / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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