Pituitary function in patients with primary and secondary empty sella

BackgroundDue to the increasing availability and sensitivity of neuroradiological imaging, the number of incidental findings of empty sella (ES) is rising, however, the clinical relevance is not clearly defined.MethodsIn this longitudinal, single-center study patients with first-time diagnosed prima...

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Main Authors: Lucas Steckel, Elke R. Gizewski, Susanne Kaser
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1632824/full
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author Lucas Steckel
Elke R. Gizewski
Elke R. Gizewski
Susanne Kaser
author_facet Lucas Steckel
Elke R. Gizewski
Elke R. Gizewski
Susanne Kaser
author_sort Lucas Steckel
collection DOAJ
description BackgroundDue to the increasing availability and sensitivity of neuroradiological imaging, the number of incidental findings of empty sella (ES) is rising, however, the clinical relevance is not clearly defined.MethodsIn this longitudinal, single-center study patients with first-time diagnosed primary or secondary empty sella were analyzed and followed up for five years. Hormone deficiencies were diagnosed by measuring basal pituitary and target organ hormone levels or dynamic stimulation tests.ResultsOverall, 119 patients, 97 with primary (PES) and 22 with secondary empty sella (SES) were included. At baseline, isolated or total pituitary insufficiency was detected in 34% of patients with PES and 63.6% of patients with SES. While hypogonadism was the most common finding in PES affecting 25.8% of patients, adrenal insufficiency was the most frequent finding in SES affecting 54.5% of patients. Only two patients with intact pituitary function at baseline, one with SES and one with PES, were diagnosed with hormone insufficiency during follow-up.ConclusionsHormone deficiency is common in empty sella, with males and patients with SES being at highest risk. In patients with intact pituitary function at time of diagnosis, the risk of developing hypopituitarism is low thus not justifying regular follow-up assessments.
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spelling doaj-art-eabb252e2ed345e09d716f102f1626d32025-08-20T03:27:43ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16328241632824Pituitary function in patients with primary and secondary empty sellaLucas Steckel0Elke R. Gizewski1Elke R. Gizewski2Susanne Kaser3Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Radiology, Medical University of Innsbruck, Innsbruck, AustriaNeuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Internal Medicine I, Medical University of Innsbruck, Innsbruck, AustriaBackgroundDue to the increasing availability and sensitivity of neuroradiological imaging, the number of incidental findings of empty sella (ES) is rising, however, the clinical relevance is not clearly defined.MethodsIn this longitudinal, single-center study patients with first-time diagnosed primary or secondary empty sella were analyzed and followed up for five years. Hormone deficiencies were diagnosed by measuring basal pituitary and target organ hormone levels or dynamic stimulation tests.ResultsOverall, 119 patients, 97 with primary (PES) and 22 with secondary empty sella (SES) were included. At baseline, isolated or total pituitary insufficiency was detected in 34% of patients with PES and 63.6% of patients with SES. While hypogonadism was the most common finding in PES affecting 25.8% of patients, adrenal insufficiency was the most frequent finding in SES affecting 54.5% of patients. Only two patients with intact pituitary function at baseline, one with SES and one with PES, were diagnosed with hormone insufficiency during follow-up.ConclusionsHormone deficiency is common in empty sella, with males and patients with SES being at highest risk. In patients with intact pituitary function at time of diagnosis, the risk of developing hypopituitarism is low thus not justifying regular follow-up assessments.https://www.frontiersin.org/articles/10.3389/fendo.2025.1632824/fullprimary empty sellahypopituitarismclinical courseendocrine assessmentssecondary empty sella
spellingShingle Lucas Steckel
Elke R. Gizewski
Elke R. Gizewski
Susanne Kaser
Pituitary function in patients with primary and secondary empty sella
Frontiers in Endocrinology
primary empty sella
hypopituitarism
clinical course
endocrine assessments
secondary empty sella
title Pituitary function in patients with primary and secondary empty sella
title_full Pituitary function in patients with primary and secondary empty sella
title_fullStr Pituitary function in patients with primary and secondary empty sella
title_full_unstemmed Pituitary function in patients with primary and secondary empty sella
title_short Pituitary function in patients with primary and secondary empty sella
title_sort pituitary function in patients with primary and secondary empty sella
topic primary empty sella
hypopituitarism
clinical course
endocrine assessments
secondary empty sella
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1632824/full
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