Presentation and Clinical Features

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The three main presenting features are similar to pituitary adenomas: endocrine disturbance, headache and visual impairment. In a recent large series of over 28 RCCs [1], the mean age at presentation was 45 years. Clinically, endocrine disturbance was the most common presentation (50%), including amenorrhea (37.5% of female patients), growth retardation, impotence and DI. Biochemically, hypopitu-itarism, hyperprolactinemia and gonadotrophin deficiencies were the common endocrine findings. Headache was a major feature in 32.1% and visual disturbance in14.3%. Patterns of visual disturbance included central field loss as well as the peripheral field loss expected in sellar region lesions. Four patients had pre-operative DI, a feature that, in the authors' opinion, excludes pituitary adenoma.

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