Preoperative and postoperative features of non-functioning pituitary adenomas: a single center experience

Year 2019, , 827 - 835, 04.09.2019

Pınar Şişman , Buket Özbiçer Özen Öz Gül , Soner Cander Halime Soyak Canan Ersoy

https://doi.org/10.18621/eurj.415248

Abstract

Objectives:
The main purposes of surgical treatment for non-functioning
pituitary adenomas are removal of the pressure on the surrounding structures,
especially the hypophyseal gland and visual tissue, and the normalization of
hypophyseal functions. In our study, we retrospectively reviewed postsurgical
follow-up of patients with non-functioning pituitary adenoma treated at our
institution in a period of 15 years of monitoring and evaluated surgical
success, complication rate and recurrence rates in accordance with the
literature.

Methods: This study
included 55 patients who had undergone surgery between 2000 and 2014 and who
were followed-up postoperatively at our center. Preoperative and postoperative
anterior pituitary hormones, complete resection and recurrence and also
postoperative recovery of endocrinological and ophthalmological functions were
statistically evaluated using file data of the patients.

Results: There were 33 (60%) males and 22 (40%)
females. It was observed that the adenoma caused pressure
on the optic chiasm in 11 patients and infiltrated cavernous sinus in 9 patients.
Postoperative mean follow-up was 75.14 ± 43.01 months. Seventeen (30.9%) patients
had recurrence after complete resection. Postoperative persistence and
deterioration rates were 12.2% and 26.6% in adrenal insufficiency, 12.2% and
26.6% in central hypothyroidism, respectively, while 12.2% worsening in central
hypogonadism. Ophthalmologic findings were resolved in 62.5% of patients and
persisted in 37.5% of the patients.

Conclusions: The
adenoma size and experience of the surgeon in non-functioning pituitary
adenomas are the most important factors affecting surgical success. We
recommend that operations should be performed in experienced centers,
preoperative and postoperative endocrinological evaluations and long-term
follow-up should be done. 

Keywords

Pituitary adenoma, non-functioning, surgery

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