Abstract #1168064: Surgical Management of Giant Prolactinomas

Yogi-Morren, Divya; Pantalone, Kevin M.; Recinos, Pablo F.; Kshettry, Varun R.; Rao, Pratibha

doi:10.1016/j.eprac.2022.03.256

Cited by 1 publication

(1 citation statement)

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“…In the particular case of large and giant PAs, surgery might aim to treat symptoms derived from mass effect (optic nerve compression, for example) but avoid complications that might occur if GTR was aimed. (45,46) Moreover, we showed that tumors in the LARGE group had ki67 >3% two times more frequently than those in the non-LARGE group. These ndings were similar to other studies, such as the series of Cai et al that showed that the maximum dimension of the tumor was an independent risk factor for a high ki67 index (47).…”

Section: Discussionmentioning

confidence: 77%

Clinical presentation and surgical outcomes of very large and giant pituitary adenomas: 80 cases in a cohort study of 306 patients

Pascual-Corrales,

Cancela,

Baonza

et al. 2023

Preprint

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Purpose To identify differences in the presentation and surgical outcomes between very large (30–39 mm) and giant (≥40mm) (LARGE group) pituitary adenomas (PAs) compared to the smaller group (< 30mm) (non-LARGE group). Methods Eighty patients with very large (n = 44) or giant (n = 36) PAs and 226 patients in the non-LARGE group who underwent tumor resection by pituitary surgery between 2008 and 2023 were studied. Hormonal, radiological, ophthalmological, and pathological data and surgical outcomes were evaluated. Results Preoperatively, patients of the LARGE group presented more frequently with visual impairment (82.5% vs. 22.1%, P < 0.001) and with apoplexy (15.0% vs. 2.7%, P < 0.001) than the non-LARGE group. Moreover, the LARGE group is more commonly associated with preoperative panhypopituitarism (28.8% vs. 6.2%, P < 0.001). This group presented cavernous sinus invasion more frequently (71.3% vs. 23.9%, P < 0.001). The non-LARGE group achieved surgical cure more often than the LARGE group (79.7% vs. 50.0%, P < 0.001), and the rate of major complications was higher in the latest (8.8% vs. 1.3%, P < 0.004). Conclusions PAs ≥30 mm are most frequently accompanied by hormonal dysfunction, cavernous sinus invasion, and visual impairment. All this implies lower resection rates and higher postoperative complications than small adenomas, posing a real surgical challenge.

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Section: Discussionmentioning

confidence: 77%