Evidence of improved surgical outcome following endoscopy for nonfunctioning pituitary adenoma removal

Messerer, Mahmoud; Battista, Juan Carlos De; Raverot, Gérald; Kassis, S.; Dubourg, Julie; Lapras, V.; Trouillas, Jacqueline; Perrin, Gilles; Jouanneau, Emmanuel

doi:10.3171/2011.1.focus10308

Cited by 140 publications

(101 citation statements)

References 42 publications

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“…Nowadays, this approach is becoming the first-line technique and most of pituitary surgeons are shifting to the endoscopic technique because of the excellent visualization of supra and para-sellar compartments it provides and a painless shorter postoperative course. Despite the absence of randomized studies proving definitely the superiority of endoscopic surgery upon microsurgery, the recent literature is accumulating evidence in favor of endoscopy especially for non-functioning pituitary adenomas (Dehdashti et al, 2008;Kassis et al 2009 ;Frank et al, 2006, Higgins et al, 2008Messerer et al, 2011;Schaberg et al, 2010). The rate of gross total removal is definitely higher in endoscopic series than in microscopic ones, for such adenomas.…”

Section: Endoscopic Endonasal Pituitary Surgerymentioning

confidence: 98%

“…Postoperative anterior pituitary dysfunction may occur in 13% to one third of patients with pituitary adenomas managed endoscopically, depending of the preoperative condition (Messerer et al, 2011). Endocrine results are clearly poorer for craniopharyngiomas while unclear or sparse for the other sellar tumors.…”

Section: Endocrinological Issuesmentioning

confidence: 99%

“…Higher experience in pituitary surgery means rarer CSF leaks, less than 5% (Messerer et al, 2011). Obviously, extensive approaches involving the anterior skull base are more likely to lead to per and postoperative CSF leaks.…”

Section: Csf Leak and Meningitismentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic Endonasal Skull Base Surgery: Current State of the Art and Future Trends

Jouanneau¹,

Messerer²,

Berhouma³

2011

Advances in Endoscopic Surgery

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Section: Endoscopic Endonasal Pituitary Surgerymentioning

confidence: 98%

Section: Endocrinological Issuesmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Endonasal Skull Base Surgery: Current State of the Art and Future Trends

Jouanneau¹,

Messerer²,

Berhouma³

2011

Advances in Endoscopic Surgery

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“…Ensenat et al [ 34 ] and Messerer et al [ 102 ] compared patients with non-functional pituitary adenomas who underwent TS tumor resection with either an endonasal endoscopic or purely microscopic approach. Both studies demonstrated a significantly higher rate of gross total resection in the endoscopic group (60% vs. 35% and 74% vs. 50%, respectively).…”

Section: Pituitary Adenomasmentioning

confidence: 99%

Transsphenoidal endoscopic skull base surgery: state of the art and future perspective

Cutler

Barkhoudarian

Griffiths³

et al. 2013

Innovative Neurosurgery

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Given refinements in endoscopic image quality, instrumentation, surgical navigation, skull base closure techniques and anatomical understanding, the endonasal endoscopic approach is now a well-accepted and widely utilized technique for removal of many if not most midline ventral skull base tumors. Pituitary adenomas and Rathke ' s cleft cysts (RCCs) constitute the majority of lesions removed via this route; however, craniopharyngiomas, clival chordomas, midline meningiomas and other benign and malignant skull base tumors are now increasingly removed by this approach. Herein we describe the evolution of the endonasal endoscopic technique, its current use for sellar and midline skull base tumors and potential for future innovation.

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“…Surgical resection represents the mainstay of treatment, and this is typically via an endoscopic endonasal approach (5). However, complete resection may be challenging due to the firm consistency and highly vascularised nature of these tumours.…”

Section: Introductionmentioning

confidence: 99%

An exceptional presentation of pituicytoma apoplexy: A case report

et al. 2018

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Abstract. Pituicytomas are a rare form of indolent neoplasms, which typically present with visual disturbance and hypopituitarism. Complete resection by a trans-sphenoidal approach is the optimal treatment. Only 80 cases have been described thus far in the current literature and the present case is the first to describe the development of pituitary apoplexy in the context of a pituicytoma. A 77-year-old man presented with fatigue and clinical signs of hypogonadism and a sellar lesion was diagnosed at cerebral magnetic resonance imaging (MRI). A watch-and-wait management was initially decided and 1 year after the initial diagnosis, he presented with a thunderclap headache with images suggestive of pituitary apoplexy. A pituitary adenoma was suspected and an endoscopic resection was decided upon the development of a visual deficit. Pathological analysis established the correct diagnosis of a pituicytoma. Pituicytomas are characterised by dense vascularisation, thus ischaemic and haemorrhagic events may be common. When confronted with a hypervascularised pituitary lesion demonstrating strong contrast enhancement and no abnormal hormonal secretion, one must maintain a high index of suspicion for a pituicytoma. A wide range of differential diagnoses should thus be considered in the context of pituitary apoplexy. IntroductionPituicytomas are rare slow-growing tumours arising from the glial cells of the neurohypophysis and infundibulum (pituicytes). The histogenesis, natural history and prognosis of these lesions still need to be elucidated, as data in the current literature remain scarce.Since the first reported case in 1955 (1), there has been a surge in the number of case reports and small case series describing this rare entity. There are no gender-specific differences in the incidence of pituicytomas, and the average age of presentation is 50 years of age (2). No specific risk factors were identified. These neoplasms generally present with headaches, visual disturbances and manifestations of hypopituitarism (typically sexual dysfunction). The clinical presentation is almost identical to other more frequent sellar lesions, therefore correctly diagnosing these lesions can be challenging. Of about 80 cases described in the literature up until now (3), only one previous case reported an abrupt onset of clinical features and this was due to an intraventricular haemorrhage (4).On imaging, even if pituicytomas present with suspicious radiological peculiarities, their rarity often leads them to be misdiagnosed for more common lesions. Surgical resection represents the mainstay of treatment, and this is typically via an endoscopic endonasal approach (5). However, complete resection may be challenging due to the firm consistency and highly vascularised nature of these tumours.We report a novel case of a pituicytoma presenting as pituitary apoplexy, with the aim to advance a hypothesis to explain this phenomenon. To our knowledge this is the first reported case in the literature that describes the development of pituitary ap...

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Evidence of improved surgical outcome following endoscopy for nonfunctioning pituitary adenoma removal

Cited by 140 publications

References 42 publications

Endoscopic Endonasal Skull Base Surgery: Current State of the Art and Future Trends

Endoscopic Endonasal Skull Base Surgery: Current State of the Art and Future Trends

Transsphenoidal endoscopic skull base surgery: state of the art and future perspective

An exceptional presentation of pituicytoma apoplexy: A case report

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