2025 Poster Presentations
P231: VISION LOSS AT PRESENTATION IS ASSOCIATED WITH INCREASED LIKELIHOOD OF PITUITARY TUMOR RECURRENCE
Sayak R Ghosh, BS; Anne Lally, BS; Isabella L Pecorari, BS; Vijay Agarwal, MD; Montefiore Medical Center
Introduction: Pituitary tumors are most commonly benign lesions of the central nervous system. They vary in their composition, and the estimated prevalence in the general population is 16.7%. Functional tumors may present with a wide spectrum of symptoms due to the secretion of hormones, while both non-functional and functional tumors can present with symptoms of mass effect. A common symptom of pituitary tumors is visual impairment, due to their proximity to the optic chiasm. Some studies demonstrate a relationship between tumor volume and rates of visual impairment. However, the literature on the association between visual impairment and rates of tumor recurrence is limited.
Objective: In this single-center study, we aimed to determine if presence of vision loss at presentation in patients with pituitary tumors was associated with an increased tumor volume and an increased likelihood of tumor recurrence.
Methods: We conducted a retrospective chart review of patients treated for pituitary adenoma between 2017 and 2023 at single academic tertiary care center. A total of 125 patients were included in this study. By race, 65 (52%) patients were Black, 11 (9%) patients were White, 2 (2%) were Asian, and 47 (38%) were other or declined to respond. By ethnicity, 39 (31%) patients were Hispanic/Latino, 72 (58%) were non-Hispanic/Latino, and 14 (11%) declined to respond. Vision loss was determined to be any presence of vision loss within one year prior to tumor resection. Tumor volume was calculated using the traditional formula: (AP x CC x TR)/2, where AP, CC, and TR refer to the three dimensions of the tumor in centimeters. Recurrence was defined as tumor recurrence at any point following resection.
Results: Our analysis showed that vision loss at presentation was associated with a significantly larger tumor volume in cubic centimeters (11.5 [95% CI (8.0, 14.9); n=52] vs. 3.1 [95% CI (2.2, 3.9); n=31]; p<0.0001****). Using Fisher’s exact test to analyze differences in rates of recurrence compared to expected values, patients who presented with vision loss had an increased likelihood of tumor recurrence (34.7% vs. 14.6%; p=0.03*). Next steps include correlating to extent of resection.
Conclusion: In our study, we found that visual impairment was associated with an increased likelihood of tumor recurrence. More studies need to be done to better understand why pituitary tumors can recur and subsequently how to prevent recurrence.