Successful treatment for giant pituitary adenomas through diverse transcranial approaches in a series of 15 consecutive patients

Guo, Fuyou; Song, Laijun; Bai, Jie; Zhao, Peichao; Sun, Hongwei; Liu, Xianzhi; Yang, Bo; Wang, Shukai

doi:10.1016/j.clineuro.2012.01.033

Cited by 20 publications

(6 citation statements)

References 18 publications

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“…Multiple studies have been conducted on the resection rates of GPA. The extent of resection varies from 14.7% and 22.2% gross total resection reported by Mortini et al and Wang et al to 46.5% and 67% reported by Nakao et al and Guo et al [ 2 , 5 , 6 , 10 , 12 , 15 , 16 ]. However, it must be noted that Guo et al used a transcranial approach in all patients.…”

Section: Discussionmentioning

confidence: 99%

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AKU Giant Pituitary Adenoma Score: A Novel Scoring System to Predict the Outcomes of Surgery for Giant Pituitary Adenomas

Enam¹,

Ghazi²,

Raghib³

et al. 2022

Cureus

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BackgroundNo scoring system is available to predict the extent of resection of giant pituitary adenomas (GPAs) based on magnetic resonance imaging (MRI) parameters. We developed a novel AKU Giant Pituitary Adenoma (AGPA) score and assessed the predictive ability of the scoring system concerning the extent of resection of GPAs. MethodologyWe retrospectively collected data of patients presenting with GPAs and used our scoring system to assess the surgical resection of these tumors. The Lundin-Pederson (ABC/2) method was used to calculate the pre-and post-resection tumor volume. The relationship between the extent of resection and the AGPA score was assessed using linear regression. The AGPA score considered the tumor's extension into various planes. The maximum total score was 9. ResultsThe scoring system was applied to 45 patients with GPA who underwent surgical resection. The mean resected tumor volume (%) was 82.0 ± 16.7, and the overall mean AGPA score was 4.2 ± 0.8. The pairwise correlation between the resected tumor volume and the overall AGPA scores showed a strong inverse association (r = -0.633, p < 0.001). A significant difference was detected between the estimated scores of 3 and 5 and 4 and 5 (p < 0.001). ConclusionsAGPA score is inversely related to the extent of the tumor to be resected, which would help surgeons predict the amount of tumor resection possible as well as predict the difficulty of surgery and plan optimal preoperative patient counseling. In addition, it can predict if staging and a transcranial approach are required.

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Section: Discussionmentioning

confidence: 99%

“…Multiple studies have been conducted on the resection rates of GPA. The extent of resection varies from [2,5,6,10,12,15,16]. However, it must be noted that Guo et al used a transcranial approach in all patients.…”

Section: Discussionmentioning

confidence: 99%

AKU Giant Pituitary Adenoma Score: A Novel Scoring System to Predict the Outcomes of Surgery for Giant Pituitary Adenomas

Enam¹,

Ghazi²,

Raghib³

et al. 2022

Cureus

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“…Residual tumor on the temporal lobe was expected with an endoscopic endonasal approach, considering the limitations of endoscopic endonasal visualization beyond the immediate suprasellar region into the temporal fossa. Given the final pathologic diagnosis demonstrated a benign, WHO I pituitary adenoma with a low Ki-67 index <2%, we chose to monitor the residual tumor with surveillance imaging, rather than pursue further surgery via a transcranial approach, which has been described as a primary or staged approach for complex, giant pituitary macroadenomas in patients, typically with pre-existing visual and/or hormonal deficits ( 10 – 12 ). Surveillance imaging of our patient has not revealed tumor growth, but if this were to occur, we would pursue stereotactic radiosurgery as the least invasive option to the patient, a strategy that has previously been reported to result in durable local tumor control ( 13 ), prior to considering further options such as a second surgery via an open approach.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Suprasellar Pituitary Adenoma Presenting With Temporal Lobe Seizures

et al. 2020

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Seizures in patients with pituitary pathology are uncommon and typically secondary to electrolyte disturbances. Rarely, seizures have been described from mass effect related to large prolactinomas undergoing medical treatment. We describe a 54 year-old male who presented with a first-time generalized seizure, secondary to a pituitary macroadenoma compressing the left temporal lobe. His seizures abated after endoscopic endonasal debulking of the tumor. This report highlights isolated seizures as a potential sole presenting symptom of pituitary macroadenomas without visual or endocrine dysfunction. Prompt surgical debulking to relieve mass effect on the temporal lobe may effectively prevent further seizure activity.

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“…We had 05 patients operated with an adenoma in eight or hourglass shape with a double component supra and sub-diaphragmatic, by endoscopic endonasaltranssphenoidal technique and at a second time by transcranial technique where the quality of resection was limited to the sub diaphragmatictumor portion.It is well known that the consistency of the tumor plays an important role in achievingthe maximum possible tumor resection by transsphenoidalapproach (20)(21)(22)(23)(24)(25)(26)(27)(28).For example a giant adenoma may be amenable to total resection when the tumor is soft and easily removed by aspiration. On the other hand fibroids (representing 5-7.5% of large pituitary adenomas), are difficult to reduce despite using dissectors, curettes, ultrasonic aspiration.…”

Section: Discussionmentioning

confidence: 99%

What Remains of Transcranial Surgery in The Treatment of Pituitaryadenomas

Bouaita¹,

Shabay.²,

Ioualalen³

2017

IOSR

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Successful treatment for giant pituitary adenomas through diverse transcranial approaches in a series of 15 consecutive patients

Cited by 20 publications

References 18 publications

AKU Giant Pituitary Adenoma Score: A Novel Scoring System to Predict the Outcomes of Surgery for Giant Pituitary Adenomas

AKU Giant Pituitary Adenoma Score: A Novel Scoring System to Predict the Outcomes of Surgery for Giant Pituitary Adenomas

Case Report: Suprasellar Pituitary Adenoma Presenting With Temporal Lobe Seizures

What Remains of Transcranial Surgery in The Treatment of Pituitaryadenomas

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