Diagnosis and treatment of pituitary microadenoma: report of 80 cases.

Abstract

OBJECTIVE:

To analyse and discuss the diagnosis and treatment of pituitary microadenoma.

SUBJECTS AND METHODS:

Eighty cases of pituitary microadenoma treated with transsphenoidal approach in our department were analysed retrospectively during the last 2 years.

RESULTS:

During following-up of 13.0+/-3.2 months, neither remained tumor was found except one patients with microprolactinoma, nor recurrence. Diabetes insipidus occurred in 19 patients, among which 15 patients recovered in 1 week, three in 1 month and one in 7 months. The adrenocorticotrophic hormone deficiency was found in nine of 63 patients with PRL-, GH- and non-functioning microadenoma (12%), but hypoadrenalemia recovered in all patients. Among these nine patients, seven recovered in 3 months and two in 6 months. Dysosphesia occurred in 32 cases: 30 recovered in 1 month and two in 4 months. Thirteen of 15 patients (86.7%) with ACTH-secreting microadenoma achieved chemical remission judged by plasma cortisol levels<or=2 microg/dl within 72 hours of surgery. During the mean 13.0 months of follow-up, the symptoms of amenorrhea, galactorrhea, headache, obesity and sexual disturbance were improved greatly. In total, 93.7% (45/48) of patients had normal post-operative PRL levels in the patients who had no pre-operative treatment history of long time medical therapy and large dose medical therapy in short time.

CONCLUSIONS:

(1) Transsphenoidal surgery (TSS) is safe and effective treatment for pituitary microadenoma; (2) TSS is considered to be definitive treatment for ACTH- and GH-secreting microadenoma once the diagnosis is established; (3) in order to obtain better effects, TSS could be offered as first-line treatment for patients with locally non-invasive PRL-secreting microadenoma (tumor larger than 3 mm in diameter) and non-functioning microadenoma.

• Authors: Hong-Wei Zhang, Wei Sun, Jun Yang, Chang-Xiang Yan, Chun-Jiang Yu
• Journal: Neurological research (Neurol Res) Vol. 30 Issue 6 Pg. 587-93 (Jul 2008) ISSN: 0161-6412 [Print] England
• PMID: 18647498 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adrenocorticotropic Hormone
• Prolactin

Topics

• Adenoma (diagnosis, metabolism, therapy)
• Adolescent
• Adrenocorticotropic Hormone (metabolism)
• Adult
• Female
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Pituitary Neoplasms (diagnosis, metabolism, therapy)
• Postoperative Complications
• Prolactin (metabolism)
• Retrospective Studies