Descriptive analysis and outcomes of PitNETs treated surgically during pregnancy and postpartum

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Pituitary neuroendocrine tumors (PitNETs) are rare tumors, and surgical management during pregnancy is even rarer.
• Limited data exists on the characteristics and outcomes of PitNETs treated surgically during pregnancy compared to non-pregnant individuals.

Purpose of the Study:

• To describe the clinical, radiological, and histological profiles of PitNETs surgically treated during pregnancy.
• To compare the outcomes and long-term prognosis of PitNETs in pregnant versus non-pregnant women.

Main Methods:

• Multicentric, observational, and retrospective study design.
• Inclusion of 10 patients who underwent surgical treatment for PitNETs during pregnancy or within 12 months postpartum.
• Comparison with 30 matched non-pregnant controls, analyzing clinical, histological data, and progression-free survival.

Main Results:

• PitNETs in pregnant women exhibited higher mitotic activity and were more frequently classified as grade 2b (Trouillas classification).
• No significant differences were observed in tumor volume or radiological invasion markers between pregnant and non-pregnant groups.
• A higher need for second-line treatment was noted in the pregnant group.

Conclusions:

• PitNETs requiring surgical intervention during pregnancy are associated with increased proliferative activity and post-surgical progression.
• Despite aggressive features, the long-term prognosis for PitNETs treated during pregnancy appears favorable.
• Larger studies are needed to confirm these findings and refine management strategies.