Analysis of Pituitary Tumors in a Single Center in Slovakia and Review of the Literature

Abstract Background Pituitary adenomas are the most common pituitary lesions, with an incidental prevalence ranging from 14 to 23%. Less common pituitary lesions include craniopharyngioma, Rathke's cleft cyst, and, in rare cases, pituitary carcinomas. The objective of this retrospective observational study was to analyze the characteristics of pituitary tumors in a single center, including hormone production, morphological features and treatment strategies. Methods and Results This study analyzed data from 174 patients diagnosed with pituitary adenomas at a single center in a university hospital between 2009 and 2024 (97 women, 77 men, aged 25–92 years). The diagnosis of pituitary tumors was based on laboratory and imaging findings. Of these patients, 129 were diagnosed with macroadenomas (74.1%), 41 with microadenomas (23.6%), and 4 (2.3%) with picoadenomas. Surgical resection was performed in 90 patients (51.7%). Histological analysis of resected macroadenomas revealed the following subtypes: 32 (38.6%) null cell adenomas, 21 (25.3%) gonadotroph adenomas, 18 (21.7%) somatotroph adenomas, 5 (6%) prolactinomas, 4 (4.8%) corticotroph adenomas, and 3 patients (3.6%) with somatomammotroph adenomas. Postoperative dynamic testing revealed hypopituitarism in 82 patients (91.1%). Among these, gonadotropin deficiency was observed in 59 patients (65.6%), TSH deficiency in 68 (75.6%), GH deficiency in 40 (44.4%), and diabetes insipidus in 13 (14.4%). A total of 61 patients (71.1%) required hydrocortisone replacement therapy. Conclusion In this cohort of 174 patients with pituitary adenomas, nonfunctioning macroadenomas represented the most common tumor type. A relatively high proportion of patients were diagnosed with postoperative hypopituitarism, highlighting the need for careful endocrine follow-up after surgical intervention.