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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Long-term survival with non-functioning pituitary carcinoma - case report -
Junji Koyama1, Koji Ikeda, Yoshiteru Shose
1Department of Neurosurgery, Nishiwaki Municipal Hospital, Nishiwaki, Hyogo, Japan. jkoyama@med.kobe-u.ac.jp
Neurologia Medico-Chirurgica
|October 30, 2007
Summary
A recurrent pituitary adenoma, despite multiple surgeries and radiation, highlights the importance of histological evaluation for distant metastases in managing this rare tumor. This case demonstrates long-term survival with aggressive, non-malignant pituitary disease.
Area of Science:
- Neuro-oncology
- Endocrinology
- Neurosurgery
Background:
- Pituitary adenomas are common tumors, but malignant transformation into pituitary carcinomas is rare.
- Non-functioning pituitary adenomas can present with mass effects, such as visual disturbances and hormonal imbalances.
- Recurrent pituitary adenomas require careful management strategies, including surgical resection and radiation therapy.
Observation:
- A 35-year-old woman with a non-functioning pituitary adenoma experienced amenorrhea and visual impairment.
- The patient underwent multiple surgical resections for tumor recurrences and dural metastases over 22 years.
- Gamma knife surgery was used for residual tumor, and subsequent imaging revealed new tumor sites.
Findings:
- Histological examination confirmed typical pituitary adenoma without malignant transformation in all surgical specimens.
- Despite multiple recurrences and dural metastases, the patient survived for 22 years from initial presentation.
- The patient survived for 6 years after the first dural metastasis was identified.
Implications:
- Aggressive surgical management of distant pituitary adenoma lesions is crucial for histological evaluation and guiding treatment.
- Long-term survival is possible even with recurrent pituitary adenomas and dural spread, challenging the notion of uniformly poor prognosis for metastatic disease.
- This case underscores the need for comprehensive follow-up and tailored therapeutic approaches in managing complex pituitary adenoma cases.
