Document Detail


The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas.
MedLine Citation:
PMID:  1855185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1962 to 1987, 126 patients underwent trans-sphenoidal surgery for primary treatment of pituitary adenomas unassociated with clinical or biochemical evidence of hormonal overproduction. There were 73 male and 53 female patients (mean age, 50 +/- 12 years). Before surgery, 56% of the patients (70 of 124) had headaches, 74% (94 of 126) had deterioration of vision, and 12% (15 of 126) had ophthalmoplegia. Endocrine evaluation revealed the presence of hypogonadism in 75% (87 of 115), adrenal insufficiency in 36% (46 of 126), and hypothyroidism in 18% (21 of 122). Plasma prolactin was increased in 65% (56 of 86) with a mean level of 39 +/- 14 micrograms/l (normal, 3 to 20 micrograms/l). Radiologic enlargement of the sella turcica was documented in all cases: 67% (84 of 126) had enclosed and 33% (42 of 126) had invasive adenomas. After surgery, vision was normalized or improved in 75% (71 of 94) of the patients. Thyroid, adrenal, and gonadal functions were improved in 14% (three of 22), 41% (19 of 46), 11% (ten of 87), were unchanged in 82% (100 of 122), 77% (97 of 126), 89% (102 of 115), and worsened in 15% (19 of 22), 8% (ten of 126), 3% (102 of 115), respectively. Permanent diabetes insipidus occurred in 5% (seven of 126). Two patients died during the immediate postoperative period. The recurrence rate in patients with a mean follow-up of 6.4 +/- 4.2 years was 21% (15 of 71). These data indicate that trans-sphenoidal microsurgery is an effective and safe initial treatment for patients with nonsecreting pituitary adenoma and may reverse hypopituitarism.
Authors:
R Comtois; H Beauregard; M Somma; O Serri; N Aris-Jilwan; J Hardy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  68     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-08-28     Completed Date:  1991-08-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  860-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Notre-Dame Hospital, University of Montréal, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  surgery*
Adolescent
Adrenal Insufficiency / etiology
Adult
Aged
Child
Endocrine System Diseases / etiology,  surgery*
Female
Follow-Up Studies
Headache / etiology
Humans
Hypogonadism / etiology
Hypothyroidism / etiology
Male
Microsurgery
Middle Aged
Pituitary Neoplasms / complications,  surgery*
Postoperative Complications
Recurrence
Sphenoid Bone
Vision Disorders / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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