Pituitary Macroadenomas

Abstract

Objectives: To describe the demographic profile, patterns of visual disturbance and imaging studies of patients with Macroadenoma. Design: Retrospectively. Reviewed the clinical charts and neuroradiologic imaging of 125 patients who were diagnosed as cases of Macroadenoma. Duration: 2000 to 2009. Subjects and Methods: 100 patients were selected who had visual disturbances along with Macroadenomas. Age, sex, visual symptoms and other associated systemic problems of these patients were reviewed. The Neuroimaging data (Magnetic Resonance Imaging) was correlated with the clinical picture. The data was analysed using Statistical package for social sciences (SPSS). The Descriptive Statistics were calculated for age and MR findings. Results: The age ranged from 9 to 85 years (mean 42.92). Male to female ratio was 1.4: 1. 90% patients had visual disturbances including visual field defects and 10% had ocular motor nerve palsies. Tumour extension on MR studies showed optic chiasma compression in 69% patients, cavernous sinus invasion in 57% and Sphenoidal sinus invasion in 14%. Haemorrhagic foci were seen in 8% and intra tumour necrosis was found in 9% patients. Conclusions: The most common path for the extension of pituitary macroadenomas is towards the optic chiasma. Hence majority of these patients present with visual disturbances. MRI is an excellent aid to see the extent and invasion of Macroadenomas to the surrounding structures.

Compressive optic neuropathy in the setting of tumors of the chiasmal and sellar region: a review

“…Ocular motility disorders (OMD) are common in PA with CS invasion, occurring in 1.4% to 17% of patients with a conventional disease course and in 45 to 57% of patients with pituitary apoplexy [100,101,102,103]. OMD are more typical for parasellar extension of pituitary adenoma and sphenoid meningioma, and develop as a result of compression or infiltration of the medial wall of the CS by the tumor, with damage to cranial nerve (CN) III, IV, and/or VI.…”