Document Detail


Non-functioning pituitary adenomas: endocrinological and clinical outcome after transsphenoidal and transcranial surgery.
MedLine Citation:
PMID:  15216450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To study improvement of anterior pituitary function after transsphenoidal and transcranial surgery of non-functioning (NF) pituitary macro- and microadenomas. METHODS: We retrospectively examined 155 patients with NF adenomas preoperatively and 3 months, 1 year and 2 years postoperatively. 130 patients harboured a macroadenoma, 109 underwent transsphenoidal (group one), 21 transcranial surgery (group two). 25 patients presented a microadenoma (transsphenoidal surgery, group three). Endocrine studies included basal serum levels and dynamic testing of anterior pituitary partial function. Clinical symptoms and hormone replacement therapy were documented. RESULTS: Preoperatively, in group one, two and three, somatotropic function was impaired in 85, 90 and 80 %, gonadotropic in 61, 57 and 24 %, corticotropic in 31, 38 and 28 %, thyreotropic in 32, 38 and 12 % and lactotropic in 22, 38 and 32 % cases, respectively. Pituitary functions did not improve significantly after transsphenoidal or transcranial surgery. Presurgically, 63, 62 and 0 % patients complained about visual impairments, 60, 48 and 40 % about headache, 53, 24 and 36 % about fatigue and 28, 33 and 20 % about disturbance of cycle or potency. After transsphenoidal surgery, impaired vision, headache and fatigue improved within 3 months; after transcranial surgery, only headache improved. Preoperatively, pituitary malfunctions were treated adequately. Postsurgically, more patients received adrenal and thyroid hormone substitution, less patients received sex hormones than examinations proved necessary. CONCLUSION: Anterior pituitary function of NF adenoma patients did not improve significantly after transsphenoidal or transcranial surgery. After transsphenoidal surgery, most clinical symptoms normalised within 3 months. In some of the patients, substitution was not optimally adjusted to hormonal impairments.
Authors:
M Wichers-Rother; S Hoven; R A Kristof; N Bliesener; B Stoffel-Wagner
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  112     ISSN:  0947-7349     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-24     Completed Date:  2004-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  323-7     Citation Subset:  IM    
Affiliation:
Department of Clinical Biochemistry, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. Maria.Wichers@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Adenoma / surgery*
Adrenal Cortex Hormones / administration & dosage
Adult
Female
Gonadal Steroid Hormones / administration & dosage
Hormone Replacement Therapy
Hormones / physiology*
Humans
Male
Middle Aged
Pituitary Gland / physiopathology
Pituitary Neoplasms / physiopathology,  surgery*
Retrospective Studies
Skull
Sphenoid Bone
Sphenoid Sinus
Surgical Procedures, Operative / methods*
Thyroid Hormones / administration & dosage
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Gonadal Steroid Hormones; 0/Hormones; 0/Thyroid Hormones

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