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Recurrent pituitary adenomas.

F Marguth, R Oeckler

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

    Recurrent pituitary adenomas require tailored treatment strategies. Trans-sphenoidal surgery offers lower reoperation rates than transcranial approaches, especially for hormone-inactive tumors. Dopamine agonists are effective for prolactinomas.

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    Area of Science:

    • Neurosurgery
    • Endocrinology
    • Oncology

    Background:

    • Pituitary adenomas are common tumors affecting hormone regulation and vision.
    • Recurrences pose significant diagnostic and therapeutic challenges.
    • Treatment strategies evolve based on tumor activity and surgical approach.

    Purpose of the Study:

    • To analyze the diagnostic and therapeutic strategies for recurrent pituitary adenomas.
    • To compare reoperation rates based on surgical approach and tumor hormonal activity.
    • To evaluate treatment outcomes for recurrent hormone-inactive and hormone-active adenomas.

    Main Methods:

    • Retrospective analysis of 880 pituitary adenoma cases operated between 1972 and 1982.
    • Categorization of recurrences into hormone-inactive and hormone-active types.

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  • Assessment of reoperation rates, visual impairment, and hormonal excess management.

    • Main Results:

    • Overall reoperation rate was 7.75%, with 30% after transcranial surgery versus 5% after trans-sphenoidal approach.
    • Visual impairment necessitated reoperation in 29/50 hormone-inactive recurrences; 13 received combined treatment, 17 radiotherapy alone.
    • HGH-producing adenoma recurrences normalized in 22 cases, primarily with reoperation/radiotherapy or radiotherapy alone. Dopamine agonists were primary for PRL-producing adenomas.

    Conclusions:

    • The surgical approach significantly impacts recurrence reoperation rates, favoring trans-sphenoidal.
    • Management of recurrent pituitary adenomas requires individualized strategies based on tumor type and symptoms.
    • Radiotherapy should be used judiciously, especially in younger patients, while dopamine agonists are effective for prolactinomas.