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Giant pituitary adenomas.

H W Pia, E Grote, G Hildebrandt

    Neurosurgical Review
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Management of giant pituitary adenomas has improved, with reduced mortality from 30% to 6% due to advanced surgical techniques. Morbidity remains a concern, but new therapies show promise.

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    Area of Science:

    • Neurosurgery
    • Endocrinology
    • Oncology

    Background:

    • Giant pituitary adenomas present unique management challenges.
    • Increased detection rates observed with CT scans, particularly in elderly patients.
    • Tumor characteristics vary, with invasive prolactinomas common in younger patients and endocrine-inactive tumors in older individuals.

    Purpose of the Study:

    • To review the management strategies and outcomes for giant pituitary adenomas.
    • To analyze the changing incidence and presentation of these tumors.
    • To evaluate the impact of modern surgical techniques on mortality and morbidity.

    Main Methods:

    • Retrospective analysis of 77 giant pituitary adenomas from a series of 515.
    • Detailed description of tumor extent, form, and invasiveness.

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  • Evaluation of surgical outcomes including mortality and morbidity rates.

    • Main Results:

    • Mortality rates significantly reduced from 30% to 6% with improved surgical techniques (microsurgery, CUSA, Laser).
    • Morbidity, though often transient, remains a significant issue.
    • Preoperative dopamine-agonist therapy shows potential for reducing tumor size in giant prolactinomas.

    Conclusions:

    • Modern surgical interventions have drastically improved outcomes for giant pituitary adenomas.
    • Further research into neoadjuvant therapies like dopamine agonists is warranted.
    • Multidisciplinary management is crucial for optimizing patient care.