Clinical and laboratorial characterization and post-surgical follow-up of 87 patients with non-functioning pituitary macroadenomas

Abstract

Objective:It was to assess the main characteristics of patients undergoing pituitary tumor surgery.Method:Eighty-seven patients (44 men; 44.8±13 years old) were included.Results:The main symptoms were visual alterations (87.3%), headache (70.1%), diminished libido (34.4%), galactorrhea (22.9%) and hair loss (19.5%). The axes affected were gonadotropic (72.6%), thyrotropic (48.4%) and corticotropic (38.7%), without significant changes after surgery. The average largest tumor diameter was 3.1 cm before surgery and 1.56 cm after surgery. The most frequent postoperative complications were hydro-electrolyte and acid-base disorders (12%), diabetes insipidus (9%), visual field alterations (9%), liquoric fistula (8%) and nasal obstruction (7%). The patients were affected by more than one complication.Conclusion:Although a decrease in tumor volume was achieved through surgery, hormonal deficiencies persisted in most of the patients and new surgical approaches were necessary for dealing with tumor recurrence or persistence.

Characteristics and outcome of surgically treated pituitary tumours in South Africa: a single‐centre experience

“…The development of other major complications viz. CSF leak (10%), nasal bleeding (5·7%), meningitis (4·3%), cranial nerve palsies (4·3%) and hemiplegia (2·9%) is also comparable with rates from other centres; however, in a report on 570 patients with NFPA by Berker et al ., the overall complication rate was 12·1%, with low rates of postoperative CSF leak (0·8%), meningitis (0·8%), permanent DI (0·4%) and no deaths. We found a higher rate of postoperative hydrocephalus (7·1%) than that reported by others (1·4–6%) .…”

“…In our study, adjunctive radiotherapy was used in 18Á6% of patients, due to persistence of a large residual tumour following surgery. Gondim et al 19 reported the use of adjuvant radiotherapy in only 6%, and in the study by de Mello et al, 5 radiotherapy was used in 27% of the 87 patients with NFPA.…”

“…Gondim et al . reported the use of adjuvant radiotherapy in only 6%, and in the study by de Mello et al ., radiotherapy was used in 27% of the 87 patients with NFPA.…”

“…A large percentage of the latter group required multiple surgical interventions for the tumour. de Mello et al . reported that the trans‐sphenoidal approach was initially adopted in 92% of patients with macroadenomas, and trans‐cranial approach in 8%.…”

“…1,2 Other less common sellar lesions are of nonpituitary origin (neoplastic, nonneoplastic cystic lesions, inflammatory, infectious lesions, vascular lesions) or other pituitary lesions (pituitary hyperplasia, lymphocytic hypophysitis and pituitary abscess). 3,4 There have been several reports on size, 5 function, 5,6 therapeutic options, 7,8 surgical approaches 9,10 and complications 3,8,11 associated with pituitary tumours. Surgery (trans-sphenoidal or trans-cranial) is the preferred initial management in the majority of patients, unless comorbidities or other factors are present that preclude this.…”