Related Experiment Video
Updated: Jun 15, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[Treatment of clinically nonfunctioning pituitary adenomas]
Carmen Alameda Hernando1, Marcos Lahera Vargas, César Varela Da Costa
1Servicio de Endocrinología y Nutrición, Hospital Infanta Sofía, San Sebastián de Los Reyes, Madrid, Spain. carmen.alameda@salud.madrid.org
Summary
Nonfunctioning pituitary macroadenomas require treatment due to compression or deficiency symptoms. Surgery is common, but recurrence is possible, necessitating medical, surgical, or radiation therapy reviews.
Area of Science:
- Endocrinology
- Neurosurgery
- Radiation Oncology
Background:
- Clinically nonfunctioning pituitary adenomas are common adult tumors.
- Diagnosis occurs due to compression symptoms or hormonal deficiencies.
- Surgical resection is the primary treatment but often incomplete, leading to recurrence.
Purpose of the Study:
- To review the efficacy of medical, surgical, and radiation treatments for nonfunctioning pituitary macroadenomas.
- To discuss management strategies for residual or recurrent tumors.
- To highlight advancements in radiotherapy for pituitary tumors.
Main Methods:
- Review of existing literature on treatments for nonfunctioning pituitary macroadenomas.
- Analysis of outcomes for surgical, medical, and radiation therapies.
- Discussion of surveillance for microadenomas.
Main Results:
- Surgery offers resection but has high rates of incomplete removal and recurrence.
- Medical therapy provides modest tumor reduction in some cases.
- Radiotherapy, including stereotactic radiotherapy, is considered for residual or enlarging tumors to minimize complications.
Conclusions:
- Management of nonfunctioning pituitary macroadenomas involves a combination of surgery, medical therapy, and radiotherapy.
- Stereotactic radiotherapy offers a way to reduce long-term complications.
- Mcroadenomas are typically managed with surveillance.
Related Concept Videos
01:27Hormones of the Pituitary Gland
The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
01:17The Pituitary Gland
The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
01:19Cushing Syndrome II: Pathophysiology
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
01:26Cushing Syndrome I: Introduction
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...