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Kim, Cheon, Cho, Lee, Youn, Ahn, Jang, Kim, Lee, and Yi: Clinical Characteristics of 16 Patients with Pituitary Tumor Incidentally Detected by 18F-Fluorodeoxyglucose PET-CT (18F-FDG PET-CT)
Original Article
Endocrinology and Metabolism

Endocrinology and Metabolism 2010; 25(4): 321-325.

Published online: 31 December 2010

DOI: https://doi.org/10.3803/EnM.2010.25.4.321

Clinical Characteristics of 16 Patients with Pituitary Tumor Incidentally Detected by 18F-Fluorodeoxyglucose PET-CT (18F-FDG PET-CT)

Hyung Jin Kim, Gi Jeong Cheon1, A Ra Cho1, Chang Hoon Lee2, Sang Min Youn2, Se jin Ahn, Sang Eon Jang, Jung Min Kim3, Yun Yong Lee, Ka Hee Yi

Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.

1Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.

2Department of Neurosurgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.

3Department of Internal Medicine, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.

Corresponding author: Ka Hee Yi. Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, 215-4 Gongneung-dong, Nowon-gu, Seoul 139-240, Korea. Tel: +82-2-970-1211, Fax: +82-2-970-2402, khyi@kcch.re.kr

Received 8 July 2010       Accepted 8 October 2010

Copyright © 2010 Korean Endocrine Society

Abstract

Background

It is uncommon to unexpectedly discover pituitary tumor as a hypermetabolic lesion on an 18F-FDG PET-CT scan for the evaluation of an unrelated disease when the patient does not show neurological or endocrine signs and symptoms.

Methods

We retrospectively analyzed the medical records of 16 patients with pituitary tumor that was detected incidentally on 18FFDG PET-CT at the Korea Cancer Center Hospital from January 2002 to September 2009. We analyzed their clinical features in detail.

Results

On 35,505 18F-FDG PET-CT scans, 16 (0.045%) patients were diagnosed with pituitary incidentaloma. They underwent 18FFDG PET-CT for the evaluation of the state of malignancy. All of them had no signs and symptoms related to pituitary tumor. The average age of the patients was 63.3 ± 12.0 years (49-85 years). Eleven patients were men and 5 were women. The mean diameter of the tumor was 17.9 ± 5.7 mm. Most of the pituitary incidentalomas were macroadenoma. The result of tumor morphologic evaluation by the Hardy classification was as follows: 6 grade IV, 1 grade III, 3 grade II and 1 grade I. The mean standardized uptake value of the tumor was 10.6 ± 6.7. Ten patients had endocrine evaluation and they showed a normal hormone level. Among 16 patients, 4 patients received TSA and they were diagnosed with pituitary adenoma.

Conclusion

This study showed that pituitary incidentaloma discovered on 18F-FDG PET-CT was extremely rare. It was almost all non-functioning macroadenoma and this showed relatively high FDG uptake.

Keywords: 18F-FDG PET-CT, Incidental discovery, Pituitary tumor

Figures and Tables

Fig. 1
Midline sagittal section (A) and coronal section (B) of 18FDG-PET. Focal FDG uptake at the pituitary gland (arrow).
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Fig. 2
Midline sagittal (A) and coronal (B) image of gadolinium-enhanced T1 weighted MRI. 19 × 17 × 15 mm heterogeneously enhanced mass involving pituitary gland (arrow).
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Fig. 3
Graph shows the relationship between the pituitary tumor size and SUV. (Correlation coefficient r = 0.809, P < 0.01)
SUV, standardized uptake value.
enm-25-321-g003
Table 1
Characteristics of patients with pituitary incidentaloma in PET-CT
enm-25-321-i001

ca, cancer; MUO, malignancy of unknown origin; SUV, standardized uptake value; TSA, transsphenoidal approach; W.N.L, within normal limit.

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