RESULTS OF TREATMENT OF PITUITARY DISEASE IN MULTIPLE ENDOCRINE NEOPLASIA, TYPE-I

OBJECTIVE: The aim of the present study was to examine the clinical an d pathological features of pituitary disease in patients with multiple endocrine neoplasia Type I (MEN I) and to assess the prognosis. METHO DS: Fifty-two patients with pituitary disease and MEN I were studied r etrospectively. Medical records were reviewed, and all of the patients known to be alive were sent a questionnaire to ascertain current dise ase status. RESULTS: In 12 patients, pituitary disease was the initial manifestation of MEN I. The most common lesion was prolactinoma, foll owed, in frequency, by acromegaly and nonsecretory adenoma. Thirty-fou r of the patients had surgical treatment at the Mayo Clinic, Rochester , MN, as primary treatment, 3 had radiotherapy, and 12 received no spe cific therapy. Twelve patients had adjunctive radiotherapy postoperati vely. Of the 34 patients receiving surgical treatment, 33 had adenoma and 1 had adenoma and pituitary hyperplasia. Immunocytochemical examin ation demonstrated that many tumors showed reactivity for more than on e pituitary hormone. On survival analysis, no excess pituitary-related mortality was found, either in the surgically treated group or in the group as a whole. CONCLUSION: On the basis of this study, we conclude that pituitary disease is frequently the initial manifestation of MEN I; that adenomas, particularly prolactinomas, are the rule and hyperp lasia is rare; that a significant proportion of tumors are plurihormon al; and that excess pituitary-related mortality is not a factor in pat ients with MEN I.