Pituitary adenomas: Surgery and radiotherapy in the age of molecular diagnostics and pathology

McCutcheon, Ian E.

doi:10.1016/j.currproblcancer.2012.10.001

Cited by 17 publications

(13 citation statements)

References 123 publications

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“…Thyroid hormone and glucocorticoid replacement might be necessary in these patients preoperatively. They also tend to intraoperative hypotension due to increased sensitivity to general anesthetic agents (22)(23)(24)(25). In our study, intraoperative hypotension and bradycardia were more common in patients with non-functioning tumors.…”

Section: Discussionmentioning

confidence: 49%

Prevalence and risk factors of hemodynamic instability during endoscopic transsphenoidal pituitary surgery: a retrospective analysis

Acar¹,

Kilci²,

Alay

et al. 2020

Journal of Health Sciences and Medicine

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Amaç: Hipofiz adenomu için endoskopik transsfenoidal hipofiz cerrahisi geçiren hastalarda intraoperatif dönemde ortaya çıkan hemodinamik instabilite önemli komplikasyonlara yol açabilir. Bizim amacımız bu hastalarda hemodinamik instabilitenin prevalansını ve onunla ilişkili risk faktörlerini araştırmaktır. Gereç ve Yöntem: Endoskopik transsfenoidal hipofiz cerrahisi geçiren hastalarda intraoperatif dönemde ortaya çıkan bradikardi, hipotansiyon ve hipertansiyon kaydedildi. Yaş grupları, ASA sınıfı, tümör tipi ve anestezi metoduna göre hemodinamik instabilite dağılımı belirlendi. Bulgular: Toplam 323 hasta çalışma kriterlerini karşıladı. Ortalama yaş 46,88±13,91 ve %54,5'i kadın cinsiyette idi. Intraoperatif dönemde 137 hastada bradikardi (%42.41), 57 hastada hipotansiyon (%17,65) ve 5 hastada hipertansiyon (%1,55) tespit edildi, 51 yaşın üzerindeki hastaların tamamında hemodinamik instabilite görüldü. ASA III olarak sınıflandırılan hastalarda ASA I ve ASA II'ye göre daha fazla oranda hemodinamik instabilite görüldü (p<0.05). Postoperatif dönemde yoğun bakıma transport edilen 18 hastanın tamamı 61 yaş ve üzeri hasta grubunda idi. Non-functioning tümör olan hastalarda functioning tümöre sahip olanlara göre hemodinamik instabilite oranı daha yüksekti. Sonuç: ETSS sırasında hemodinamik instabilite oranı yaşlılarda, ASA III sınıfında ve çalışmayan tümörlerde daha yüksektir. Bu hastalar dikkatle planlanmış bir anestezi yönetimine ihtiyaç duyar.

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Section: Discussionmentioning

confidence: 49%

Prevalence and risk factors of hemodynamic instability during endoscopic transsphenoidal pituitary surgery: a retrospective analysis

Acar¹,

Kilci²,

Alay

et al. 2020

Journal of Health Sciences and Medicine

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“… 26 27 Pituitary adenomas are usually considered as benign tumors derived from adenohypophysis and can present either as a result of the hypersecretion of pituitary hormones and/or a result of local space-occupying effects and the hyposecretion of some or all of the pituitary hormones. 1 17 18 19 21 28 As a direct consequence, patients with pituitary adenomas not only suffer from headache, visual impairment, and acromegaly, but also suffer from lactation, sterility, irregular menstrual cycles and gynecomastia in females, and SD in males.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and the prognosis of sexual dysfunction in male patients with pituitary adenomas: a multivariate analysis

Zhou

Zhao

et al. 2018

Asian J Androl

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The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s.d.: 44.16 ± 10.14) years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients (62.6%) complained of SD prior to surgery. The mean International Index of Erectile Function (IIEF-5) in patients with giant adenomas was 16.13 ± 2.51, much smaller than those with microadenomas or macroadenomas (P < 0.05). All the patients showed significant improvement in terms of erectile dysfunction (ED) following surgery (P < 0.05). In addition, complete resection achieved a higher degree of SD relief than partial resection. The incidence of SD in functioning pituitary adenomas (FPAs) was much higher than that in nonfunctioning pituitary adenomas (NFPAs) (P < 0.05). In addition, compared with NFPAs, males with prolactinomas (82.8%) had the higher prevalence of SD and significantly improvement following surgical intervention (P < 0.05). An inverse relationship was identified between decreasing testosterone levels and increasing incidence of SD before surgery (P < 0.05). There was no significant difference between 6 months and 12 months after surgery in serum testosterone level (P > 0.05). Our results indicated that surgical therapy could be optimized for improvements in SD and that testosterone levels can be used as a sensitive indicator to predict the recovery rate of sexual function in patients with pituitary adenomas following surgery and the serum testosterone level will stay stable in 6 months after surgery.

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“…Typically, endocrinology is involved in the preoperative and postoperative management of patients with pituitary adenomas. Surgical removal of these lesions is the first step in treatment with the goal to suppress overactive hormone secretion, reduce the tumor mass, preserve normal pituitary function and prevent recurrence [4]. Surgical removal can occur through several different approaches depending on the size and invasiveness of the lesion, although typically, an endonasal transspenoidal approach is preferred.…”

Section: Tumor Differential Diagnosis and Treatmentmentioning

confidence: 98%

Tumors of the anterior skull base

Ivan

Han

Aghi³

2014

Expert Review of Neurotherapeutics

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A variety of histologic tumor types are present in the anterior skull base. Primary tumors of this area may be derived from the bone, paranasal sinuses, nasopharynx, dura, cranial nerves, pituitary gland and brain. Symptoms are caused mostly through mass effect but, if the tumor becomes aggressive, also through invasion. Selection of surgical approaches to the anterior skull base is based upon balancing risk reduction with maximizing extent of resection. Here we review a spectrum of neoplastic entities found in the anterior skull base in adults and discuss clinical and radiographic presentation, treatment options, and outcomes. Surgical resection remains the mainstay in treatment of these tumors, particularly in the hands of experienced surgeons exercising proper patient and case selection.

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Pituitary adenomas: Surgery and radiotherapy in the age of molecular diagnostics and pathology

Cited by 17 publications

References 123 publications

Prevalence and risk factors of hemodynamic instability during endoscopic transsphenoidal pituitary surgery: a retrospective analysis

Prevalence and risk factors of hemodynamic instability during endoscopic transsphenoidal pituitary surgery: a retrospective analysis

Risk factors and the prognosis of sexual dysfunction in male patients with pituitary adenomas: a multivariate analysis

Tumors of the anterior skull base

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