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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Nonfunctioning giant pituitary adenomas: Invasiveness and recurrence
José Alberto Landeiro1, Elissa Oliveira Fonseca2, Andrea Lima Cruz Monnerat2
1Department of Neurosurgery, Hospital Universitário Antônio Pedro, Rio de Janeiro, Brazil.
Surgical Neurology International
|December 18, 2015
Summary
Giant nonfunctioning pituitary adenomas (GNFPAs) can recur, especially when the Ki-67 antigen expression is over 3%. This study analyzed 35 GNFPA cases to understand recurrence predictors.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Giant nonfunctioning pituitary adenomas (GNFPA) present unique surgical challenges.
- Understanding predictors of recurrence is crucial for patient management.
Purpose of the Study:
- To analyze the surgical outcomes in 35 patients with GNFPA.
- To evaluate the role of Ki-67 antigen expression in predicting GNFPA recurrence.
Main Methods:
- Retrospective analysis of 35 GNFPA patients operated between 2000-2010.
- Endoscopic transsphenoidal surgery as the primary approach.
- Immunohistochemical analysis of Ki-67 labeling index (LI) and hormonal receptors.
Main Results:
- Surgical interventions included 49 procedures (44 transsphenoidal, 5 transcranial).
- Significant improvement in visual acuity (80%) and visual field defects (73.9%) post-surgery.
- Recurrence was observed in 3 patients with Ki-67 LI >3%.
Conclusions:
- While surgery improves symptoms, GNFPA recurrence is a concern.
- Ki-67 LI >3% is associated with an increased risk of recurrence in GNFPA patients.
