2015
DOI: 10.1016/j.ando.2015.04.003
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Post-surgical management of non-functioning pituitary adenoma

Abstract: Post-surgical surveillance of non-functioning pituitary adenoma (NFPA) is based on magnetic resonance imaging (MRI) at 3 or 6 months then 1 year. When there is no adenomatous residue, annual surveillance is recommended for 5 years and then at 7, 10 and 15 years. In case of residue or doubtful MRI, prolonged annual surveillance monitors any progression. Reintervention is indicated if complete residue resection is feasible, or for symptomatic optic pathway compression, to create a safety margin between the tumor… Show more

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Cited by 70 publications
(34 citation statements)
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References 107 publications
(158 reference statements)
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“…Reoperation may be an option in case of tumor regrowth or recurrence. However, it must be underlined that results obtained after a second operation are generally inferior to those obtained after the first operation: indeed, a remnant persists in 72% of cases and visual recovery is more rarely achieved (58 vs 90%) (95). Moreover, there is a higher risk of complications (96), with an increased rate of diabetes insipidus (26 vs 16%, P = 0.03), cerebrospinal fluid leak (4 vs 1%, P = 0.04), meningitis (3 vs 0.4%, P = 0.02) and longer mean hospital stay (4.5 vs 2.8 days, P = 0.006).…”
Section: Reoperationmentioning
confidence: 98%
“…Reoperation may be an option in case of tumor regrowth or recurrence. However, it must be underlined that results obtained after a second operation are generally inferior to those obtained after the first operation: indeed, a remnant persists in 72% of cases and visual recovery is more rarely achieved (58 vs 90%) (95). Moreover, there is a higher risk of complications (96), with an increased rate of diabetes insipidus (26 vs 16%, P = 0.03), cerebrospinal fluid leak (4 vs 1%, P = 0.04), meningitis (3 vs 0.4%, P = 0.02) and longer mean hospital stay (4.5 vs 2.8 days, P = 0.006).…”
Section: Reoperationmentioning
confidence: 98%
“…In addition, given treatment-related hypopituitarism, particularly radiation effects on pituitary endocrine function, which can occur many years following therapy, we recommend a full endocrine evaluation to monitor adrenal, thyroid and sex steroid functions at least yearly, or more often if clinical symptoms suggest dysfunction (28). R 4.3 We recommend lifelong follow-up of patients with aggressive pituitary tumours (++00).…”
Section: Reasoningmentioning
confidence: 99%
“…The imaging protocol should comprise thin (2-3 mm) sagittal T1, coronal T1 before and after gadolinium injection, coronal T2 or axial T1-weighted slices. Comparison with penultimate and prior remote imaging studies is essential to identify tumour progression and to guide appropriate treatment (28). …”
Section: Reasoningmentioning
confidence: 99%
“…, transient diabetes insipidus (DI)15.3%(27), permanent DI 6.8%(12), cerebrospinal fluid (CSF) leak 4.5% (8) and cardiac events 1.1% (2). One patient needed removal of retained nasal packs (0.6%).…”
mentioning
confidence: 99%