2025 Poster Presentations
P232: FACTORS ASSOCIATED WITH PITUITARY TUMOR VOLUME: SOCIAL VULNERABILITY AND BMI
Sayak R Ghosh, BS; Anne Lally, BS; Isabella L Pecorari, BS; Vijay Agarwal, MD; Montefiore Medical Center
Introduction: Pituitary tumors are the most commonly encountered intracranial neoplasm, with prevalence in the general population estimated to be anywhere between 5% and 20%. They can present with a wide variety of clinical manifestations, including symptoms of excess secretion of hormone, other symptoms due a deficit of hormone secretion, and symptoms due to mass effect and compression of adjacent structures, including the optic chiasm. The latter is much related to tumor size and volume, as a larger tumor is more likely to impinge on nearby structures. Tumor volume ranges greatly. Frequently, these tumors are less than 10 mm and are discovered incidentally at autopsy, labeled as microadenomas. On the flip side, they can be quite large, even invading the cavernous sinus. The literature is limited on what patient factors are associated with tumor volume. At our institution in the Bronx, we treat patients who are socially vulnerable and often who have a high BMI.
Objective: In this single-center study, we aimed to determine if social vulnerability and body mass index (BMI) are associated with size of pituitary tumors.
Methods: We conducted a retrospective chart review of patients treated for pituitary adenoma between 2017 and 2023 at a single academic tertiary care center. A total of 153 patients were included in this study. By race, 79 (51.6%) patients were Black, 14 (9.2%) patients were White, 2 (1.3%) were Asian, and 58 (37.9%) were other or declined to respond. By ethnicity, 50 (32.6%) patients were Hispanic/Latino, 86 (56.2%) were non-Hispanic/Latino, and 17 (11.1%) declined to respond. Social Vulnerability Index (SVI) scores were collected for each patient based upon home address, drawn from a series of metrics from 2020 census data, with a higher value indicating greater social disadvantage. 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.
Results: In our study population, mean SVI was 0.8115 (95% CI [0.7749, 0.8480]; n=153), mean BMI was 31.91 kg/m2 (95% CI [30.88, 32.95]; n=150), and mean tumor volume was 8.00 cm3 (95% CI [5.98, 10.03]; n=97). Analysis using simple linear regression showed that increased social vulnerability was associated with a decreased tumor volume (r2 = 0.06, p = 0.02*). Furthermore, simple linear regression showed that increased BMI was also associated with decreased tumor volume (r2 = 0.05, p = 0.03*).
Conclusion: In our study, we elucidated patient factors that were associated with variations in tumor volume, namely social vulnerability and BMI. Interestingly, increased social vulnerability was associated with a decreased tumor volume at presentation, which goes against the idea that those who have limited access to healthcare present later in their tumor progression. It would be beneficial to further analyze what factors about the socially vulnerable are responsible for their decreased pituitary tumor volumes.