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Are nonfunctioning pituitary adenomas extending into the cavernous sinus aggressive and/or invasive?
S Yokoyama1, H Hirano, K Moroki
1Department of Neurosurgery, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. yokoyama@m2.kufm.kagoshima-u.ac.jp
Neurosurgery
|September 21, 2001
Summary
Nonfunctioning pituitary adenomas extending into the cavernous sinus are typically benign. Their frequent extension may be due to a weaker medial wall of the cavernous sinus, not tumor invasiveness.
Area of Science:
- Neurosurgery
- Endocrinology
- Pathology
Background:
- Nonfunctioning pituitary adenomas (NFAs) frequently extend into the cavernous sinus.
- The reason for this extension, despite the histologically benign nature of NFAs, remains unclear.
Purpose of the Study:
- To investigate the factors contributing to the cavernous sinus extension of NFAs.
- To determine if tumor aggressiveness or anatomical sinus wall characteristics play a role.
Main Methods:
- Compared 10 patients with NFAs extending into the cavernous sinus to 10 controls without extension.
- Assessed tumor growth via MRI, immunostaining for proliferation markers (Ki-67) and matrix enzymes.
- Examined the histological thickness of the cavernous sinus walls in cadavers.
Main Results:
- No significant tumor growth observed during follow-up (mean 65.8 months).
- No difference in proliferation markers or matrix enzymes between groups.
- Cavernous sinus medial wall was significantly thinner than superior and lateral walls (P < 0.0005).
Conclusions:
- NFA extension into the cavernous sinus is likely due to benign tumor behavior.
- Weakness of the medial cavernous sinus wall may facilitate adenoma extension.
- Tumor invasiveness is not the primary driver of cavernous sinus invasion.