Pituitary adenoma consistency affects postoperative hormone function: a retrospective study

Abstract

Background Tumor consistency recently emerged as a key factor in surgical planning for pituitary adenomas, but its impact on postoperative endocrine function is still unclear. Our study aimed to evaluate the impact of tumor consistency on the development of postoperative pituitary deficiencies. Methods Single-center, retrospective analysis of consecutive pituitary surgeries performed between January 2017 and January 2021 at Policlinico Umberto I in Rome. All patients underwent radiological and biochemical evaluations at baseline, and hormone assessments 3 and 6 months after pituitary surgery. Postoperative MRI studies were used to determine resection rates following surgery. Data on tumor consistency, macroscopic appearance, neurosurgical approach, and intraoperative complications were collected. Results Fifty patients [24 women, mean age 57 ± 13 years, median tumor volume 4800 mm3 [95% CI 620–8828], were included. Greater tumor volume (χ2 = 14.621, p = 0.006) and male sex (χ2 = 12.178, p < 0.001) were associated with worse preoperative endocrine function. All patients underwent transsphenoidal adenomectomy. Fibrous consistency was observed in 10% of patients and was associated with a Ki-67 greater than 3% (χ2 = 8.154, p = 0.04), greater risk of developing postoperative hormone deficiencies (χ2 = 4.485, p = 0.05, OR = 8.571; 95% CI: 0.876–83.908), and lower resection rates (χ2 = 8.148, p = 0.004; OR 1.385, 95% CI; 1.040–1.844). Similarly, worse resection rates were observed in tumors with suprasellar extension (χ2 = 5.048, p = 0.02; OR = 6.000, 95% CI; 1.129–31.880) and CSI (χ2 = 4.000, p = 0.04; OR = 3.857, 95% CI; 0.997–14.916). Conclusions Tumor consistency might provide useful information about postoperative pituitary function, likely due to its impact on surgical procedures. Further prospective studies with larger cohorts are needed to confirm our preliminary findings.

Tall stature and gigantism in transition age: clinical and genetic aspects—a literature review and recommendations

“…Moreover, patients with T2-hypointense adenomas also have higher IGF1 values at baseline [ 151 , 152 ]. T2-weighted signal intensity is a marker for the granulation pattern [ 153 , 154 ]; accordingly, T2-hypointense adenomas have been linked with better hormonal responses and greater tumour shrinkage after presurgical somatostatin analogue administration [ 151 , 153 , 155 ]. Currently, the few data reporting MRI findings in the paediatric and transition-age population mainly derive from retrospective studies.…”

Nasal Irrigation Improves the Nasal Related Quality of Life in Patients Undergoing Transsphenoidal Resection of Pituitary Adenoma

“…The incidence of pituitary adenomas accounts for about 10%-15% of intracranial tumors (Daly & Beckers, 2020). Pituitary adenomas will not only cause symptoms such as vision loss, visual field defect, dizziness and vomiting because of their space-occupying effects, such as invading the surrounding tissues such as optic chiasma and hypothalamus, but also disturb the hormone balance in the body due to excessive secretion of hormones by the pituitary gland, resulting in a series of endocrine disorders such as Cushing syndrome and acromegaly (De Alcubierre et al, 2023;Han et al, 2023;Tritos & Miller, 2023). Therefore, patients with symptomatic pituitary adenomas should be actively treated.…”