Interrelationships between tumour size, age, plasma growth hormone and incidence of extrasellar extension in acromegalic patients

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Abstract
In 44 consecutive acromegalic patients the interrelationships between tumor size, age, incidence of extrasellar extension, growth hormone levels and tumor growth were studied. These parameters were compared with results from a previous study in 62 prolactinoma patients. It appeared that the incidence of extrasellar extension in acromegalic patients was lower than in the prolactinoma patients (32 vs. 44%). In acromegalic patients extrasellar extension occurred on the average at a lateral sellar and tumor area of almost 1 cm2 larger than in prolactinoma patients (with respect to sellar size generally above 3 cm2 vs. 2 cm2. with respect to tumor size generally above 4 cm2 vs. 3 cm2). Log tumor size and log basal growth hormone level were positively correlated (P < 0.0005). In the acromegalic patients there was a negative correlation between the size of the pituitary tumor and the age of the patient (P < 0.005) in contrast to the absence of such a relationship in the prolactinoma patients. In the group of acromegalic patients mean tumor size decreased gradually from the 3rd to the 6th decade (5.0, 3.8, 3.0 and 2.3 cm2, respectively). The interval between the time of appearance of symptoms and the time of diagnosis was significantly shorter in younger patients and in women. The restriction of large tumors (lateral area > 5 cm2) to young patients (< 35 yr) and the short period between the appearance of symptoms and the time of diagnosis in these patients indicate that growth hormone secreting pituitary tumors generally grow more rapidly in younger patients.