Endocrinological Differences Between Partial and Complete Primary Empty Sella: A Comparative Analysis

Akcura C., Guney S. C., Alkan S., Ovali G. Y., HEKİMSOY Z., ÖZDEMİR N.

Neuroendocrinology Letters, cilt.46, sa.2, ss.86-90, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 46 Sayı: 2
  • Basım Tarihi: 2025
  • Dergi Adı: Neuroendocrinology Letters
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.86-90
  • Anahtar Kelimeler: complete primary empty sella, partial primary empty sella, secondary adrenal insufficiency, secondary hypogonadism, secondary hypothyroidism
  • Manisa Celal Bayar Üniversitesi Adresli: Evet

Özet

OBJECTIVES: Empty sella is the herniation of the subarachnoid space into the sella turcica; either secondary to identifiable causes (e.g., surgery or radiotherapy); or spontaneously, which is termed primary empty sella (PES). The amount of cerebrospinal fluid (CSF) in the sella on imaging classifies PES as partial (<50% filling, pituitary >2 mm) or complete (≥50% filling, pituitary <2 mm). Few investigations have compared hormonal abnormalities in partial and complete PES. DESIGN: This study aims to determine whether partial and complete PES differ endocrinologically. MATERIAL AND METHODS: Fifty-eight PES patients underwent hormonal evaluation: morning corticotropin (ACTH), cortisol, thyrotropin (TSH), free thyroxine (fT4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (females), total testosterone (males), prolactin (PRL), growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Patients were divided into partial and complete PES groups and endocrinologically assessed. RESULTS: The proportion of secondary adrenal insufficiency and secondary hypogonadism was significantly higher in the complete PES group (p = 0.021 and p = 0.041, respectively). The proportion of cases with two or more affected axes was higher in complete PES (p = 0.010). Secondary hypothyroidism was significantly more common among males (p = 0.001). CONCLUSION: After a diagnosis of complete PES, clinicians should be cautious about secondary adrenal insufficiency and hypogonadism. It is advisable to perform hormonal testing for all PES patients, regardless of type, because affected-axis rates often exceed 10% and may reach 50%. Prospective multicenter trials are necessary.