Microneurosurgery and subsequent gamma knife radiosurgery for functioning pituitary macroadenomas or giant adenomas: One institution’s experience

Fu, Peng; He, Yunsong; Cen, Yongcun; Huang, Qin; Guo, Ke-tai; Zhao, Hongyang; Xiang, Wei

doi:10.1016/j.clineuro.2016.03.021

Cited by 10 publications

(4 citation statements)

References 23 publications

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“…Patients with giant pituitary adenoma or tumors extending towards the hypothalamus have more pronounced diaphragm sellar sinking, which consequently stretches and damages the pituitary stalk and posterior pituitary. In this study, adenomas were classified into macroadenomas (1–4 cm) and giant adenomas (> 4 cm) according to the tumor diameter [ 24 ]. Although the size of giant adenomas is relatively large and greater changes in the craniocaudal diameter of the tumor cavity may occur after surgery, the latter can be tackled by intraoperative packing with gelatin sponge.…”

Section: Discussionmentioning

confidence: 99%

Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma

Lin

Fan

et al. 2022

Eur J Med Res

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Objective To assess the factors influencing the development of diabetes insipidus after transsphenoidal surgery for pituitary adenomas. Methods We retrospectively analyzed the clinical data of patients with pituitary adenoma who underwent transsphenoidal surgery. The pituitary gland was assessed using a 3.0 T magnetic resonance imaging, and the predictors of postoperative diabetes insipidus were determined through univariate and multivariate analyses. Results A total of 212 eligible patients with pituitary adenomas were included; 82 (38.7%) cases developed postoperative diabetes insipidus while 130 cases (61.3%) did not. Diabetes insipidus was transient in 80 (37.7%) patients and permanent in 2 (0.9%) patients. The results of logistic regression analyses showed that the change in cephalocaudal tumor cavity diameter after transsphenoidal surgery was associated with the occurrence of postoperative diabetes insipidus. Conclusions Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery may play an important role in predicting diabetes insipidus onset in patients with a pituitary adenoma.

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Section: Discussionmentioning

confidence: 99%

Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma

Lin

Fan

et al. 2022

Eur J Med Res

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“…In one study of 59 patients who underwent surgery followed by stereotactic radiosurgery for functioning macroadenomas and giant adenomas, 7 patients had visual deterioration. 13 Hence, first-line treatment with dopamine agonists should be considered, with surgery reserved for acute compression symptoms and dopamine resistance. With dopamine-resistant invasive prolactinomas, PRL normalization with surgery is unlikely.…”

Section: Discussionmentioning

confidence: 99%

“…In one study of 59 patients who underwent surgery followed by stereotactic radiosurgery for functioning macroadenomas and giant adenomas, 7 patients had visual deterioration. 13 …”

Section: Discussionmentioning

confidence: 99%

Management of giant prolactinoma causing craniocervical instability: illustrative case

Chugh¹,

Patel²,

Chua

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Giant prolactinomas (>4 cm) are a rare entity, constituting less than 1% of all pituitary tumors. Diagnosis can usually be achieved through endocrinological analysis, but biopsy may be considered when trying to differentiate between invasive nonfunctioning pituitary adenomas and primary clival tumors such as chordomas. OBSERVATIONS The authors presented a rare case of a giant prolactinoma causing significant clival and occipital condyle erosion, which led to craniocervical instability. They provided a review of the multimodal management. Management involved medical therapy with dopamine agonists, and surgery was reserved for acute neural compression or dopamine agonist resistance, with the caveat that surgery was extremely unlikely to lead to normalization of serum prolactin in dopamine agonist–resistant tumors. LESSONS Adjunctive surgical therapy may be necessary in cases of skull base erosion, particularly when erosion or pathological fractures involve the occipital condyles. Modern posterior occipital-cervical fusion techniques have high rates of arthrodesis and can lead to symptomatic improvement. This procedure should be considered early in the multimodal approach to giant prolactinomas because of the often dramatic response to medical therapy and potential for further craniocervical instability.

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“…The second surgeries were similar to the first, and they both recovered without problems. 11 patients in our series underwent a postoperative gamma knife treatment, which is a safe and effective treatment for PA [35,36]. In our opinion, EEEA surgery and …”

Section: Gtrmentioning

confidence: 99%

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

et al. 2017

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Microneurosurgery and subsequent gamma knife radiosurgery for functioning pituitary macroadenomas or giant adenomas: One institution’s experience

Cited by 10 publications

References 23 publications

Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma

Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma

Management of giant prolactinoma causing craniocervical instability: illustrative case

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

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