Combined Endoscopic Transsphenoidal and Tubular Retractor-Assisted Transventricular Approach for Giant Pituitary Adenomas

Guinto-Nishimura, Gerardo Yoshiaki; Caballero-Delgado, Silvia; Eguiluz‐Melendez, Aldo; Ortega-Porcayo, Luis Alberto; Valencia-Ramos, Cristopher; Aragón-Arreola, Jorge Fernando; Portocarrero-Ortíz, Lesly; Sangrador-Deitos, Marcos V; Gómez-Amador, Juan Luis

doi:10.1016/j.wneu.2021.08.135

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…In endoscopic transsphenoidal surgery, it is difficult to remove tumors that have extended to the suprasellar area, ventricles, or cavernous sinus, and there is also a possibility of postoperative bleeding from residual tumors. It has been reported that simultaneous surgery is preferable because it may be possible to remove Simultaneous surgery with a transsphenoidal approach includes microscopic surgery, [4,8,16] transcranial surgery with a rigid endoscope, [6,11,13] and use of a tubular retractor [3,16] that have been reported. However, even among giant pituitary adenomas, prolactinomas are treated differently from the other giant pituitary adenomas.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that simultaneous surgery is preferable because it may be possible to remove the tumor by adding craniotomy to transsphenoidal surgery. Simultaneous surgery with a transsphenoidal approach includes microscopic surgery,[ 4 , 8 , 16 ] transcranial surgery with a rigid endoscope,[ 6 , 11 , 13 ] and use of a tubular retractor[ 3 , 16 ] that have been reported. However, even among giant pituitary adenomas, prolactinomas are treated differently from the other giant pituitary adenomas.…”

Section: Discussionmentioning

confidence: 99%

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A case of acute hydrocephalus due to a giant prolactinoma rescued by transventricular neuroendoscopic tumorectomy

Iwamura¹,

Nonaka²,

Li³

et al. 2023

Surgical Neurology International

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Background: A giant prolactinoma extending to the suprasellar area and causing hydrocephalus may be life-threatening and should be treated promptly. A case of a giant prolactinoma with acute hydrocephalus that underwent transventricular neuroendoscopic tumor resection followed by cabergoline administration is presented. Case Description: A 21-year-old man had a headache lasting for about a month. He gradually developed nausea and disturbance of consciousness. Magnetic resonance imaging showed a contrast-enhanced lesion that extended from the intrasellar space to the suprasellar space and into the third ventricle. The tumor obstructed the foramen of Monro and caused hydrocephalus. A blood test showed marked elevation of prolactin (16,790 ng/mL). The tumor was diagnosed as a prolactinoma. The tumor in the third ventricle had formed a cyst, and the cyst wall blocked the right foramen of Monro. The cystic component of the tumor was resected using an Olympus VEF-V flexible neuroendoscope. The histological diagnosis was pituitary adenoma. The hydrocephalus improved rapidly and his consciousness became clear. After the operation, he was started on cabergoline. The tumor size subsequently decreased. Conclusion: Prompt partial resection of the giant prolactinoma by transventricular neuroendoscopy resulted in early improvement of hydrocephalus with less invasiveness, allowing subsequent treatment with cabergoline.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case of acute hydrocephalus due to a giant prolactinoma rescued by transventricular neuroendoscopic tumorectomy

Iwamura¹,

Nonaka²,

Li³

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…6,10,11 There have even been reported instances of growth reaching the third and lateral ventricles in more extreme cases. 12,13 Of note, most of these more invasive tumors consist of nonfunctioning adenomas or growth hormone-secreting adenomas. 11 As described by the authors in the operative video, their patient presented with a pituitary adenoma with a sizeable Knosp Grade 4 extension beyond the sella, predominantly involving the lateral cavernous sinus and retrocarotid space.…”

mentioning

confidence: 99%