Growth Patterns of Pituitary Adenomas and Histopathological Correlates

Abstract

Our data suggest that the growth rate of PAs are influenced by various patient- and tumor-specific characteristics including the age and sex of the patient, the specific subtype of PA, its hormonal activity, its immunohistochemical profile including the mindbomb homolog 1 labeling index status, and its preponderance for different growth directions relative to the pituitary fossa. Furthermore, the pre- and postoperative PA growth rates were correlated, suggesting that postoperative PA growth rates can be predicted, in part, by preoperative growth rates, thus better informing postoperative outcome.

Perioperative lumbar drain utilization in transsphenoidal pituitary resection

“…ACTHsecreting tumors were also associated with higher CSF leak rates; 5,14 we found ACTH-secreting adenomas in 2 patients who developed a postoperative leak. In accordance with the literature, 3 the majority of tumors were nonfunctional in both groups, with 42 )82.3%( nonfunctional tumors in group 1 and 73 )54%( in group 2 )p<0.001(. CSF leak grading.…”

“…Histopathological subtype aids in predicting the behavior of pituitary adenomas in terms of invasion of surrounding structures such as CS, optic chiasm, or regrowth after surgery. 3 The most common histopathological subtype was non-staining adenoma )23.5%(, followed by prolactin-secreting adenoma )14.9%(, Follicle Stimulating Hormonesecreting adenoma )12%(, and adrenocorticotrophic hormone )ACTH(-secreting adenoma )12%(. ACTHsecreting tumors were also associated with higher CSF leak rates; 5,14 we found ACTH-secreting adenomas in 2 patients who developed a postoperative leak.…”

“…2 Pituitary adenomas are common primary brain tumors in adults representing 25% of cranial neoplasms. 3 The transsphenoidal approach, through the skull base, carries the risk of CSF leak, which is one of the most common complications of skull base operations. 4 It can present either preoperatively, intraoperatively, or postoperatively, and the role of lumbar drain )LD( in each instance is controversial.…”

Atypical pituitary adenoma with <i>MEN1</i> somatic mutation associated with abnormalities of DNA mismatch repair genes; <i>MLH1</i> germline mutation and <i>MSH6</i> somatic mutation

“…Generally, the TVDT in pituitary adenoma is approximately three to five years [15][16][17], whereas in our case it was about two months. According to the immunohistochemical analysis of Ki-67 proliferation index and p53, the pituitary tumor was categorized as an atypical pituitary adenoma.…”

“…1A(c) (d)) with about two-fold enlargement in two months. Notably, previous studies reported that the tumor volume doubling time (TVDT) of pituitary adenoma was about three to five years [15][16][17]. Therefore, we performed eTSS again and were able to remove most of the tumor (Fig.1A(e)).…”