[Diagnosis, treatment and course of hypophyseal tumors. Retrospective study of 123 cases].

To assess the diagnostic and therapeutic problems associated with pituitary tumors, the clinical records of 123 consecutive patients presenting with radiological changes consistent with pituitary tumors were analyzed retrospectively. This diagnosis was established in 109 cases while the remaining 14 had other intrasellar pathologies. Prolactinoma in women was diagnosed at a significantly younger age (34.3 years) than in men (54.2 years) or than non-secreting adenoma in both sexes (52.1 years). In the two latter instances there was, on diagnosis, a larger proportion of visual field impairment due to tumor impingement on the visual pathway. Acromegaly was also recognized late, when skeletal changes were marked. The presence of certain symptoms could have suggested the diagnosis of pituitary tumor earlier in most cases. Surgical treatment was somewhat less effective in correcting hormone hypersecretion than in other series but, on the other hand, it caused less pituitary insufficiency and, thus, less additional discomfort to the patients. Hypopituitarism was frequent after transcranial surgery and radiotherapy (more than 50%) but was very rare after transsphenoidal tumorectomy. It appears that earlier diagnosis would result in less frequent visual impairment and hypopituitarism secondary to tumor extension and the necessary treatment.