https://orcid.org/0000-0003-0464-3014
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Esteban Cordero Asanza, Antonio Biroli, Carlos Pérez-López, Marta Araujo-Castro, Rosa Cámara, Fernando Guerrero-Pérez, Almudena Vicente, Cristina Lamas, Guillermo Serra, Ana Irigaray Echarri, M Dolores Ollero, Inmaculada González Molero, Rocío Villar-Taibo, María Dolores Moure Rodríguez, Pablo García Feijoo, Víctor Rodríguez Berrocal, Noelia Sánchez, Alba Gutiérrez Hurtado, Vanessa Capristan-Díaz, Andreu Simó-Servat, Marta Gallach, Eva Safont Pérez, Victoria González Rosa, Soralla Civantos Modino, Edelmiro Menéndez Torre, Anna Aulinas, Pedro Iglesias, Juan J Diez, Verónica Rodríguez-Hernández, Albert Puig-Pérez, Elisa Blangini, Ignacio Bernabéu, Cristina Álvarez-Escolá, Silvana Sarria-Estrada, Manel Puig-Domingo, Fuat Arikán Abelló, Elena Martínez-Sáez, Betina Biagetti, On behalf of Neuroendocrinology Task Force of Spanish Society of Endocrinology, Age-related differences in the clinical features and management of pituitary apoplexy: a cohort study, European Journal of Endocrinology, Volume 192, Issue 4, April 2025, Pages 356–363, https://doi.org/10.1093/ejendo/lvaf056
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Abstract
Pituitary apoplexy (PA) is a rare and acute condition resulting from hemorrhage or infarction of the pituitary gland. This study aimed to assess clinical characteristics, management, and outcomes of PA in patients aged <65 and ≥65 years using data from a Spanish multicenter cohort.
We conducted a retrospective, multicenter study (2010-2023) of 301 PA patients from 18 Spanish hospitals. Data were analyzed for differences in demographics, clinical presentation, treatment approach, and outcomes.
Patients aged ≥65 years (n = 116, 38.5%) had more comorbidities, compared to younger patients (n = 185, 61.5%). No significant differences were observed in clinical presentation, including PA Score and radiological findings except for higher frequency of cranial nerve palsy (46.2 vs. 64.9%; P = .02) in older patients. Surgical (n = 209), and conservative (n = 92) treatment rates were similar between groups (conservative: 29.9 younger vs. 32.8% older; P = .51). Histopathological analysis revealed more necrosis in patients aged ≥65 years (66.7 vs. 80.6%; P = .04). Surgical resection rates and outcomes including mortality were comparable across age groups.
PA management and outcomes were comparable in younger and older patients, despite greater comorbidities and more severe symptoms in older individuals. Histopathological findings suggest potential age-related differences in tumor biology, warranting further research. MRI would be preferred for diagnosis, particularly in older patients, as ischemic necrotic PA may be undiagnosed without advanced imaging.
