alexa Transsphenoidal microsurgery of pituitary macroadenomas with long-term follow-up results.


Journal of Brain Tumors & Neurooncology

Author(s): Ciric I, Mikhael M, Stafford T, Lawson L, Garces R

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Abstract The authors have reported on 108 patients with pituitary macroadenomas (measuring 2 cm in at least one diameter) who underwent 117 transsphenoidal operations and five craniotomies, and were followed for periods ranging from 6 months to 14 years. Vision improved in 90\% of the patients. Gross total tumor removal with no evidence of residual tumor tissue demonstrable on the postoperative computerized tomography scan was accomplished in 41\% of cases. However, gross total tumor removal is not synonymous with complete tumor removal. Endocrine cure was possible in 25\% of prolactin-secreting and 20\% of growth hormone-secreting adenomas. The incidence of recurrence was 12\%, with the majority occurring from 4 to 8 years postoperatively. Both the tumors with suprasellar extension of more than 2 cm and the hard fibrotic tumors had a higher recurrence rate. Postoperative administration of radiation therapy has been associated with a significantly lower recurrence rate than when this therapy was withheld. Transsphenoidal surgery of pituitary macroadenomas confined to the extra-arachnoid space is associated with a relatively small number of complications. The operative technique used in this series is described. This article was published in J Neurosurg and referenced in Journal of Brain Tumors & Neurooncology

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