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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Non-functioning pituitary adenomas: a single center experience.
P Anagnostis1, F Adamidou, S A Polyzos
1Endocrinology Clinic, Hippokration Hospital, 49 Konstantinoupoleos str., Thessaloniki, Greece. anagnwstis.pan@yahoo.gr
Summary
Clinically non-functioning pituitary adenomas (NFPAs) often present as macroadenomas with visual defects. While surgery improves symptoms, it increases pituitary dysfunction, and tumors frequently relapse.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Non-functioning pituitary adenomas (NFPAs) are tumors of the pituitary gland.
- These tumors lack hormonal activity but can cause symptoms due to mass effect.
Purpose of the Study:
- To characterize the clinical, imaging, and hormonal profiles of NFPAs.
- To describe the natural history and outcomes of patients with NFPAs.
Main Methods:
- Retrospective review of 114 patients with NFPAs diagnosed between 1984 and 2009.
- Evaluation included hormonal assessments and imaging at yearly intervals.
- Analysis of surgical and conservative management outcomes.
Main Results:
- 45% of NFPAs were incidental findings; 75% were macroadenomas, often with extrasellar extension.
- Headaches (53%) and visual field defects (76% of macroadenomas) were common presenting symptoms.
- 31% had pituitary axis disruption at diagnosis; surgery improved headaches (88%) and visual fields (59%) but increased permanent diabetes insipidus (2% to 15%) and pituitary deficiencies.
- Tumor size relapsed in 58% of operated cases; 83% of conservatively managed tumors remained stable.
Conclusions:
- NFPAs frequently cause pituitary dysfunction and visual impairment.
- Surgery offers symptomatic relief but carries risks of new or worsened pituitary deficiencies and tumor recurrence.
- Conservative management can be effective for maintaining tumor size stability.
