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Year 2019, Volume: 5 Issue: 5, 827 - 835, 04.09.2019

Pınar Şişman Buket Özbiçer Özen Öz Gül Soner Cander Halime Soyak Canan Ersoy

https://doi.org/10.18621/eurj.415248

Abstract

References

  • [1] Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA 2017;317:516-24.
  • [2] Tjörnstrand A, Gunnarsson K, Evert M, Holmberg E, Ragnarsson O, Rosen T, et al. The incidance rate of pituitary adenomas in western Sweden for the period 2001-2011. Eur J Endocrinol 2014;171:519-26.
  • [3] Buurman H, Saeger W. Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data. Eur J Endocrinol 2006;154:753- 6.
  • [4] Bonneville JF, Cattin F, Bonneville F. Imaging of pituitary adenomas. Presse Med 2009;38:84-91.
  • [5] Mello PA, Naves LA, Pereira Neto A, Oliveira EH, Ferreira IC, Araújo Júnior AS, et al. Clinical and laboratorial characterization and post-surgical follow-up of 87patients with non-functioning pituitary macroadenomas. Arq Neuropsiquiatr 2013;71:307-12.
  • [6] Dekkes OM, Hammer S, deKeiser RJW, Roelfsema F, Schutte PJ, Smit JW, et al. The naturel course of non-functioning pituitary macroadenomas. Eur J Endocrinol 2007;156:217-24.
  • [7] Greenman Y, Stern N. Non-functioning pituitary adenomas. Best Pract Res Clin Endocrinol Metab 2009;23:625-38.
  • [8] Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, et al; Endocrine Society. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:894-904.
  • [9] Messerer M, Dıbourg J, Raverot G, Bervini D, Berhouma M, George I, et al. Non-functioning pituitary macro-incidentalomas benefit from early surgery before becoming symptomatic. Clin Neurolo Neurosurg 2013;115:2514-20.
  • [10] Maartens NE, Kaye AH. Role of transcranial approachs in the treatment of sellar and suprasellar lesions. Front Horm Res 2006;34:1-28.
  • [11] Ferreira JE, de Mello PA, de Magalhaes AV, Botelho CH, Naves LA, Nosé V, et al. [Non-functioning pituitary adenomas: clinical features and immunohistochemistry]. Arq Neuropsiquatr 2005;63:1070-1078. [Article in Portuguese]
  • [12] Korbonits M, Carlsen E. Recent clinical and pathophysiological advances in non-functioning pituitary adenomas. Horm Res 2009;71 Suppl 2:123-30.
  • [13] Hirohata T, Ishii Y, Matsuno A. Treatment of pituitary carcinomas and atypical pituitary adenomas: a review. Neurol Med Chir (Tokyo) 2014;54:966-73.
  • [14] Saeger W, Lüdecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol 2007;156:203-16.
  • [15] Yamada S, Ohyama K, Taguchi M, Takeshita A, Morita K, Takano K, et al. A study of the correlation between morphological findings and biological activities in clinically nonfunctioning pituitary adenomas. Neurosurgery 2007;61:580-5.
  • [16] Greenman Y, Stern N. Optimal managemant of non-functioning pituitary adenomas. Endocrine 2015;50:51-5.
  • [17] Caroll WR, Cohen S, Sullivan MJ. Spontaneous CSF rhinorrhea: an unusual presentation of a pituitary adenoma. Otolaryngol Head Neck Surg 1991;104:380-3.
  • [18] Deepak D, Daousi C, Javadpour M, MacFarlane IA. Macroprolactinomas and epilepsy. Clin Endocrinol (Oxf.) 2007;66:503-7.
  • [19] Nawar RN, AbdelMannan D, Selmar WR, Arafah BM. Pituitary tumor apoplex: a review. J Intensive Care Med 2008;23:75-90.
  • [20] Semple PL, Jane JA Jr, Laws ER Jr. Clinical relevance of precipitating factors in pituitary apoplexy. Neurosurgery 2007;61:956-61;discussion 61-2.
  • [21] Honneger J, Ernemann U, Psaras T, Will B. Objective criteria for successful transsfenoidal removal of suprasellar nonfunctioning pituitary adenomas. A prospective study. Acta Neurochir (Wien) 2007;149:21-9; discusssion 29.
  • [22] Reddy R, Cudlip S, Byrne JV, Karavitaki N, Wass JA. Can we ever stop imaging in surgically treated and radiotheraphy-naive patients with non-functioning pituitary adenoma? Eur J Endocrinol 2011;165:739-44.
  • [23] Anagnostis P, Adamidou F, Polyzos SA, Efstathiadou Z, Panagiotou A, Kita M. Non-functioning pituitary adenomas: a single center experience. Exp Clin Endocrinol Diabetes 2011;119:314-9.
  • [24] Greenman Y. Present and future perspectives for medical theraphy of nonfunctioning pituitary adenomas. Eur J Endocrinol 2017;177:113-24.
  • [25] Castinelli F, Dufour H, Gaillard S, Jouanneau E, Vasiljevic A, Villa C, et al. Non-functioning pituitary adenoma: when and how to operate? What pathologic criteria for typing? Ann Endocrinol 2015;7:220-7.
  • [26] Dehdashti AR, Ganna A, Karabatsou K, GentiliF. Pure endoscopic endonasal approach for pituitary adenomas: early surgical results in 200 patients and comparison with previous microsurgical series. Neurosurgery 2008;62:1006-15.
  • [27] Losa M, Donofrio CA, Barzaghi R, Mortini P. Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients’ characteristic. Eur J Endocrinol 2013;169:735-42.
  • [28] Sauer N, Flitsch J, Doeing I, Dannheim V, Burkhardt T, Aberle J. Non-functioning pituitary macroadenomas: benefit from early growth hormone substitution after surgery. Growth Horm IGF Res 2014;24:71-5.
  • [29] Arafah BM. Medical management of hypopituitarism in patients with pituitary adenomas. Pituitary 2002;5:109-17.
  • [30] Peters JP, German WJ, Man EB, Welt LG. Functions of gonads, thyroid and adrenals in hypopituitarism. Metabolism 1954;3:118-37.
  • [31] Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinially nonfunctioning pituitary macroadenomas. J Clin Endocrinol Metab 2008;93:3717-26.
  • [32] Ciric I, Ragin A, Baumgardner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review the literatüre, and personal experience. Neurosurgery 1997;40:225-36; discussion 236-7.
  • [33] Kremer P, Forsting M, Ranaei G, Wüster C, Hamer J, Sartor K, et al. Magnetic resonance imaging after transsphenoidal surgery of clinically non-functional pituitary macroadenomas and its impact on detecting residual adenoma. Acta Neurochir (Vienna) 2002;144:433-43.
  • [34] Bonneville J-F, Cattin F, Bonneville F. Imaging of pituitary adenomas. Presse Med 2009;38:84-91.
  • [35] Cortet-Rudelli C, Bonneville JF, Borson-Chazot F, Clavier L, Coche Dequéant B, Desailloud R, et al. Post-surgical management of non-functioning pituitary adenoma. Ann Endocrinol (Paris) 2015;76:228-38.
  • [36] Losa M, Mortini P, Barzaghi R, Ribotto P, Terreni MR, Marzoli SB, et al. Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J Neurosurg 2008;108:525-32.
  • [37] Molitch ME. Pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 2009;23:667-75.
  • [38] Tampourlou M, Fountas A, Ntali G, Karavitaki N. Mortality in patients with non-functioning pituitary adenoma. Pituitary 2018;21:203-7.
  • [39] Hansen TM, Batra S, Lim M, Gallia GL, Burger PC, Salvatori R, et al. Invasive adenoma and pituitary carcinoma: a SEER database analysis. Neurosurg Rev 2014;37:279-85.

Preoperative and postoperative features of non-functioning pituitary adenomas: a single center experience

Year 2019, Volume: 5 Issue: 5, 827 - 835, 04.09.2019

Pınar Şişman Buket Özbiçer Özen Öz Gül Soner Cander Halime Soyak Canan Ersoy

https://doi.org/10.18621/eurj.415248

Abstract

Objectives:
The main purposes of surgical treatment for non-functioning
pituitary adenomas are removal of the pressure on the surrounding structures,
especially the hypophyseal gland and visual tissue, and the normalization of
hypophyseal functions. In our study, we retrospectively reviewed postsurgical
follow-up of patients with non-functioning pituitary adenoma treated at our
institution in a period of 15 years of monitoring and evaluated surgical
success, complication rate and recurrence rates in accordance with the
literature.

Methods: This study
included 55 patients who had undergone surgery between 2000 and 2014 and who
were followed-up postoperatively at our center. Preoperative and postoperative
anterior pituitary hormones, complete resection and recurrence and also
postoperative recovery of endocrinological and ophthalmological functions were
statistically evaluated using file data of the patients.

Results: There were 33 (60%) males and 22 (40%)
females. It was observed that the adenoma caused pressure
on the optic chiasm in 11 patients and infiltrated cavernous sinus in 9 patients.
Postoperative mean follow-up was 75.14 ± 43.01 months. Seventeen (30.9%) patients
had recurrence after complete resection. Postoperative persistence and
deterioration rates were 12.2% and 26.6% in adrenal insufficiency, 12.2% and
26.6% in central hypothyroidism, respectively, while 12.2% worsening in central
hypogonadism. Ophthalmologic findings were resolved in 62.5% of patients and
persisted in 37.5% of the patients.







Conclusions: The
adenoma size and experience of the surgeon in non-functioning pituitary
adenomas are the most important factors affecting surgical success. We
recommend that operations should be performed in experienced centers,
preoperative and postoperative endocrinological evaluations and long-term
follow-up should be done. 

Keywords

Pituitary adenoma non-functioning surgery

References

  • [1] Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA 2017;317:516-24.
  • [2] Tjörnstrand A, Gunnarsson K, Evert M, Holmberg E, Ragnarsson O, Rosen T, et al. The incidance rate of pituitary adenomas in western Sweden for the period 2001-2011. Eur J Endocrinol 2014;171:519-26.
  • [3] Buurman H, Saeger W. Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data. Eur J Endocrinol 2006;154:753- 6.
  • [4] Bonneville JF, Cattin F, Bonneville F. Imaging of pituitary adenomas. Presse Med 2009;38:84-91.
  • [5] Mello PA, Naves LA, Pereira Neto A, Oliveira EH, Ferreira IC, Araújo Júnior AS, et al. Clinical and laboratorial characterization and post-surgical follow-up of 87patients with non-functioning pituitary macroadenomas. Arq Neuropsiquiatr 2013;71:307-12.
  • [6] Dekkes OM, Hammer S, deKeiser RJW, Roelfsema F, Schutte PJ, Smit JW, et al. The naturel course of non-functioning pituitary macroadenomas. Eur J Endocrinol 2007;156:217-24.
  • [7] Greenman Y, Stern N. Non-functioning pituitary adenomas. Best Pract Res Clin Endocrinol Metab 2009;23:625-38.
  • [8] Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, et al; Endocrine Society. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:894-904.
  • [9] Messerer M, Dıbourg J, Raverot G, Bervini D, Berhouma M, George I, et al. Non-functioning pituitary macro-incidentalomas benefit from early surgery before becoming symptomatic. Clin Neurolo Neurosurg 2013;115:2514-20.
  • [10] Maartens NE, Kaye AH. Role of transcranial approachs in the treatment of sellar and suprasellar lesions. Front Horm Res 2006;34:1-28.
  • [11] Ferreira JE, de Mello PA, de Magalhaes AV, Botelho CH, Naves LA, Nosé V, et al. [Non-functioning pituitary adenomas: clinical features and immunohistochemistry]. Arq Neuropsiquatr 2005;63:1070-1078. [Article in Portuguese]
  • [12] Korbonits M, Carlsen E. Recent clinical and pathophysiological advances in non-functioning pituitary adenomas. Horm Res 2009;71 Suppl 2:123-30.
  • [13] Hirohata T, Ishii Y, Matsuno A. Treatment of pituitary carcinomas and atypical pituitary adenomas: a review. Neurol Med Chir (Tokyo) 2014;54:966-73.
  • [14] Saeger W, Lüdecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol 2007;156:203-16.
  • [15] Yamada S, Ohyama K, Taguchi M, Takeshita A, Morita K, Takano K, et al. A study of the correlation between morphological findings and biological activities in clinically nonfunctioning pituitary adenomas. Neurosurgery 2007;61:580-5.
  • [16] Greenman Y, Stern N. Optimal managemant of non-functioning pituitary adenomas. Endocrine 2015;50:51-5.
  • [17] Caroll WR, Cohen S, Sullivan MJ. Spontaneous CSF rhinorrhea: an unusual presentation of a pituitary adenoma. Otolaryngol Head Neck Surg 1991;104:380-3.
  • [18] Deepak D, Daousi C, Javadpour M, MacFarlane IA. Macroprolactinomas and epilepsy. Clin Endocrinol (Oxf.) 2007;66:503-7.
  • [19] Nawar RN, AbdelMannan D, Selmar WR, Arafah BM. Pituitary tumor apoplex: a review. J Intensive Care Med 2008;23:75-90.
  • [20] Semple PL, Jane JA Jr, Laws ER Jr. Clinical relevance of precipitating factors in pituitary apoplexy. Neurosurgery 2007;61:956-61;discussion 61-2.
  • [21] Honneger J, Ernemann U, Psaras T, Will B. Objective criteria for successful transsfenoidal removal of suprasellar nonfunctioning pituitary adenomas. A prospective study. Acta Neurochir (Wien) 2007;149:21-9; discusssion 29.
  • [22] Reddy R, Cudlip S, Byrne JV, Karavitaki N, Wass JA. Can we ever stop imaging in surgically treated and radiotheraphy-naive patients with non-functioning pituitary adenoma? Eur J Endocrinol 2011;165:739-44.
  • [23] Anagnostis P, Adamidou F, Polyzos SA, Efstathiadou Z, Panagiotou A, Kita M. Non-functioning pituitary adenomas: a single center experience. Exp Clin Endocrinol Diabetes 2011;119:314-9.
  • [24] Greenman Y. Present and future perspectives for medical theraphy of nonfunctioning pituitary adenomas. Eur J Endocrinol 2017;177:113-24.
  • [25] Castinelli F, Dufour H, Gaillard S, Jouanneau E, Vasiljevic A, Villa C, et al. Non-functioning pituitary adenoma: when and how to operate? What pathologic criteria for typing? Ann Endocrinol 2015;7:220-7.
  • [26] Dehdashti AR, Ganna A, Karabatsou K, GentiliF. Pure endoscopic endonasal approach for pituitary adenomas: early surgical results in 200 patients and comparison with previous microsurgical series. Neurosurgery 2008;62:1006-15.
  • [27] Losa M, Donofrio CA, Barzaghi R, Mortini P. Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients’ characteristic. Eur J Endocrinol 2013;169:735-42.
  • [28] Sauer N, Flitsch J, Doeing I, Dannheim V, Burkhardt T, Aberle J. Non-functioning pituitary macroadenomas: benefit from early growth hormone substitution after surgery. Growth Horm IGF Res 2014;24:71-5.
  • [29] Arafah BM. Medical management of hypopituitarism in patients with pituitary adenomas. Pituitary 2002;5:109-17.
  • [30] Peters JP, German WJ, Man EB, Welt LG. Functions of gonads, thyroid and adrenals in hypopituitarism. Metabolism 1954;3:118-37.
  • [31] Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinially nonfunctioning pituitary macroadenomas. J Clin Endocrinol Metab 2008;93:3717-26.
  • [32] Ciric I, Ragin A, Baumgardner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review the literatüre, and personal experience. Neurosurgery 1997;40:225-36; discussion 236-7.
  • [33] Kremer P, Forsting M, Ranaei G, Wüster C, Hamer J, Sartor K, et al. Magnetic resonance imaging after transsphenoidal surgery of clinically non-functional pituitary macroadenomas and its impact on detecting residual adenoma. Acta Neurochir (Vienna) 2002;144:433-43.
  • [34] Bonneville J-F, Cattin F, Bonneville F. Imaging of pituitary adenomas. Presse Med 2009;38:84-91.
  • [35] Cortet-Rudelli C, Bonneville JF, Borson-Chazot F, Clavier L, Coche Dequéant B, Desailloud R, et al. Post-surgical management of non-functioning pituitary adenoma. Ann Endocrinol (Paris) 2015;76:228-38.
  • [36] Losa M, Mortini P, Barzaghi R, Ribotto P, Terreni MR, Marzoli SB, et al. Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J Neurosurg 2008;108:525-32.
  • [37] Molitch ME. Pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 2009;23:667-75.
  • [38] Tampourlou M, Fountas A, Ntali G, Karavitaki N. Mortality in patients with non-functioning pituitary adenoma. Pituitary 2018;21:203-7.
  • [39] Hansen TM, Batra S, Lim M, Gallia GL, Burger PC, Salvatori R, et al. Invasive adenoma and pituitary carcinoma: a SEER database analysis. Neurosurg Rev 2014;37:279-85.
There are 39 citations in total.

Details

Primary Language English
Subjects Surgery, Endocrinology, ​Internal Diseases
Journal Section Original Articles
Authors

Pınar Şişman 0000-0002-6561-6207

Buket Özbiçer This is me 0000-0002-4771-9034

Özen Öz Gül 0000-0002-1332-4165

Soner Cander This is me 0000-0001-6303-7896

Halime Soyak This is me 0000-0003-3790-1059

Canan Ersoy 0000-0003-4510-6282

Publication Date September 4, 2019
Submission Date April 17, 2018
Acceptance Date September 29, 2018
Published in Issue Year 2019 Volume: 5 Issue: 5

Cite

AMA Şişman P, Özbiçer B, Öz Gül Ö, Cander S, Soyak H, Ersoy C. Preoperative and postoperative features of non-functioning pituitary adenomas: a single center experience. Eur Res J. September 2019;5(5):827-835. doi:10.18621/eurj.415248
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