Pituitary adenoma consistency is associated with postoperative hormonal deficits: a retrospective study on 50 patients undergoing transsphenoidal adenomectomy

2021 ◽  
Author(s):  
Alcubierre Dario De ◽  
Riccardo Pofi ◽  
Emilia Sbardella ◽  
Giulia Puliani ◽  
Valeria Hasenmajer ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pituitary Adenoma ◽  
Transsphenoidal Adenomectomy

Follow-up Management of Patients After Transsphenoidal Approach for Resection of Pituitary Adenomas

2019 ◽  
Vol 34 (2) ◽  
pp. 150-155
Author(s):  
Allison K. Ikeda ◽  
Lauren J. Luk ◽  
Zara M. Patel ◽  
Nelson M. Oyesiku ◽  
C. Arturo Solares ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Care Center ◽  
Tertiary Care ◽  
Cerebrospinal Fluid Leak ◽  
Patient Records ◽  
Tertiary Care Center ◽  
Postoperative Course ◽  
Transsphenoidal Adenomectomy ◽  
Fluid Leak

Background Endoscopic transsphenoidal adenomectomy (eTSA) is widely utilized for resection of pituitary adenoma. eTSA patients undergo healing for weeks to months and are potentially at risk for complications. Multidisciplinary follow-up monitoring is necessary. We hypothesized that patients with deviations from the routine postoperative course, broadly termed complications of interest (COI) in this study, following eTSA would increase the duration of follow-up in the rhinology clinic. Methods Retrospective review was performed on patients undergoing eTSA for pituitary adenoma from August 2007 to May 2016 at a single tertiary care center. COIs were reviewed for their influence on follow-up time. Results A total of 985 patient records were reviewed (mean age 51.0 ± 15.7 years, 55.2% female), of which, 21.1% of patients had a deviation from the expected postoperative course (7.0% rhinologic, 10.8% surgical, 0.6% perioperative medical, and 2.7% endocrinologic COIs). The most common COI was cerebrospinal fluid leak 5.6% (n = 55) followed by sinusitis 5.0% (n = 49). Moreover, 935 patients (94.9%) attended rhinology follow-up (172 patients with COI). For patients seen postoperatively by the rhinology service, COIs significantly increased the number of rhinologic follow-up visits (median 2 [interquartile range, IQR: 2–3] vs 3 visits [IQR: 2–4], P < .001), duration of rhinologic follow-up (median 54.0 days [IQR: 43.0–104.0] vs 88.0 days [IQR: 54.5–242.0], P < .001), and duration of overall multidisciplinary follow-up (median 354.0 days [IQR: 104.0–789.0] vs 537.0 days [IQR: 171.5–1313.5], P < .001), compared to those without COIs. Conclusions Patients who develop postoperative complications after eTSA have significantly extended follow-up with the multidisciplinary team.

Coagulative necrotic pituitary adenoma apoplexy: A retrospective study of 21 cases from a large pituitary center in China

Pituitary ◽  
2018 ◽  
Vol 22 (1) ◽  
pp. 13-28 ◽  
Author(s):  
Zihao Wang ◽  
Lu Gao ◽  
Wenze Wang ◽  
Xiaopeng Guo ◽  
Chenzhe Feng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pituitary Adenoma

Clinical and Pathologic Characteristics Predicted the Postoperative Recurrence and Progression of Pituitary Adenoma: A Retrospective Study with 10 Years Follow-Up

2018 ◽  
Vol 118 ◽  
pp. e428-e435 ◽  
Author(s):  
Liang Lv ◽  
Senlin Yin ◽  
Peizhi Zhou ◽  
Yu Hu ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pituitary Adenoma ◽  
Postoperative Recurrence

scholarly journals TSH-secreting pituitary adenoma in combination with primary hypothyroidism in the outcome of Hashimoto’s disease: diagnostic difficulties

2018 ◽  
Vol 14 (3) ◽  
pp. 162-168
Author(s):  
Arina V. Tkachuk ◽  
Tatiana A. Grebennikova ◽  
Anastasiya M. Lapshina ◽  
Victoria P. Vladimirova ◽  
Zhanna E. Belaya ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Immunohistochemical Analysis ◽  
Primary Hypothyroidism ◽  
Hashimoto’S Disease ◽  
Transsphenoidal Adenomectomy ◽  
Autonomously Functioning Thyroid Nodules ◽  
Diagnostic Difficulties ◽  
Hashimoto's Disease ◽  
The Brain

Despite the fact that pituitary adenomas are among the most frequent brain tumours, TSH-secreting pituitary adenomas (thyrotropinomas) are less than 1% of all adenomas. Due to the increase in the free fractions of thyroid hormones at normal or elevated TSH levels, the majority of patients with these pituitary adenomas have a long anamnesis of thyrotoxicosis which requires a differential diagnosis with thyroid pathology (Graves’ disease, toxic adenoma, autonomously functioning thyroid nodules). The diagnosis of the thyrotropinoma is quite challenging for clinicians. This article describes the case of a combination of the thyrotropinoma with primary hypothyroidism as a result of the Hashimoto’s disease. A feature of this article is the absence of a typical clinical picture of thyrotoxicosis in combination with an evaluated level of TSH on the background of constantly increasing substitution therapy for primary hypothyroidism. The picture of space-occupying lesion according to MRI of the brain allowed to suspect hormone-active pituitary adenoma (macroadenoma). As a result of surgical treatment (endonasal transsphenoidal adenomectomy), the level of TSH and free thyroid hormone levels were normalized in the postoperative period. The diagnosis of TSH-secreting pituitary adenoma was confirmed by histological and immunohistochemical analysis of postoperative material.

scholarly journals Subclinical Acromegaly: to Treat or Not to Treat?

2021 ◽  
Author(s):  
Ilan Shimon ◽  
Zaina Adnan ◽  
Dania Hirsch ◽  
Hadar Duskin-Bitan ◽  
Amit Akirov
Keyword(s):  
Weight Loss ◽  
Retrospective Study ◽  
Pituitary Adenoma ◽  
Clinical Benefit ◽  
Somatostatin Analogs ◽  
Clinical Score ◽  
Study Group ◽  
Pituitary Mass ◽  
Pituitary Microadenoma ◽  
Upper Limit

Abstract Objective Patients with acromegaly usually present with the classical signs of acromegaly, whereas patients without the specific signs or symptoms are rarely diagnosed. This unique entity can be named "subclinical acromegaly". Methods This was a retrospective study. Our study group consisted of 8 patients (6 females) with incidentally diagnosed acromegaly, most following head MRI for unrelated reasons and without the specific signs of acromegaly. Results Mean age at diagnosis was 50.1 ± 16.3 years. Baseline IGF-1 ranged between 1.27–2.08 x upper limit of normal (ULN). MRI depicted a pituitary microadenoma in 6 patients, one patient presented with an intrasellar macroadenoma and one had no visible pituitary mass. Mean calculated SAGIT clinical score was 4.6. Three patients underwent trans-sphenoidal resection; two achieved hormonal remission and one improved but did not normalize IGF-1 following surgery. Five patients (including one following surgery) were given somatostatin analogs, and three normalized IGF-1. Several patients improved clinically following treatment, reporting improvement in snoring, hypertension, or weight loss, and pituitary adenoma decreased in size in 2 patients that responded to medical treatment. Conclusions we report a series of 8 patients with very mild and subclinical acromegaly. It is uncertain whether all such patients will gain clinical benefit from treatment, but some experienced clinical improvement due to treatment.

scholarly journals Spectrum of Pituitary disorders: A retrospective study from Basrah, Iraq

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 430
Author(s):  
Abbas Ali Mansour ◽  
Ali Hussain Ali Alhamza ◽  
Ammar Mohammed Saeed Abdullah Almomin ◽  
Ibrahim Abbood Zaboon ◽  
Nassar Taha Yaseen Alibrahim ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Retrospective Study ◽  
Pituitary Adenoma ◽  
Retrospective Data ◽  
Comprehensive Description ◽  
Giant Prolactinoma ◽  
Retrospective Data Analysis ◽  
Change In Practice ◽  
Referral Bias ◽  
Southern Iraq

Background: Pituitary disorders spectrum includes a wide variety of diseases.This study aimed at a comprehensive description of such disorders for patients from  Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah (Southern Iraq). Methods: Retrospective data analysis of FDEMC for the period from January 2012 through June 2017. We included all patients with pituitary disorders who have MRI pituitary. Results: The pituitary disorders were more common among women. Those with macroadenoma were older than those with microadenoma with nearly equal gender prevalence of macroadenoma. Pituitary adenoma constituted the bulk of pituitary disorders in this registry (67.2%). Growth hormone secreting adenoma were the commonest adenoma seen in 41.0% followed by clinically non-functioning pituitary adenoma(NFPA)in 31.4% and prolactinoma in 26.9%. About 64.8% of pituitary adenoma was macroadenoma. Macroadenoma was seen in 73.4 % of growth hormone secreting adenoma, 61.2% in NFPA and 62.0% of prolactinoma (of them six were giant prolactinoma) Conclusion: Pituitary adenoma constituted the bulk of pituitary disorders in Basrah, growth hormone secreting adenoma is the commonest adenoma followed by NFPA and prolactinoma due to referral bias. A change  in  practice of pituitary adenoma treatment is needed.

scholarly journals Five years follow up of patients with Сushing’s disease with and without visualized pituitary adenoma on MRI, who underwent transsphenoidal adenomectomy

2017 ◽  
Vol 63 (5) ◽  
pp. 276-281
Author(s):  
Patimat M. Khandaeva ◽  
Zhanna E. Belaya ◽  
Lyudmila Ya. Rozhinskaya ◽  
Aleksandr V. Vorontsov ◽  
Andrey Yu. Grigoriev ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Remission Rate ◽  
Serum Cortisol ◽  
Urinary Free Cortisol ◽  
Cushing's Disease ◽  
Surgery Complications ◽  
Free Cortisol ◽  
Transsphenoidal Adenomectomy

The remission rate of Cushing’s disease in patients after neurosurgery varies from 59 to 94%, while the recurrence rate is 3 to 46%. Aim — to evaluate the five-year outcome in neurosurgery patients with Cushing’s disease (CD), depending on preoperative MRI-based identification of pituitary adenoma. Material and methods. The study included 105 neurosurgery patients with histologically confirmed CD. CD remission was confirmed by the development of adrenal insufficiency and/or normalization of serum cortisol and 24-hour urinary free cortisol (24h UFC) levels, as well as by clinical remission. Results. Pituitary adenoma was not visualized by gadolinium MRI in 35 cases. The size of visualized pituitary adenoma varied from 0.3 to 29 mm. After first neurosurgery, remission was achieved in 87 (82.8%) patients. After second neurosurgery, remission occurred in 12 patients. Radiation therapy was conducted in 24 patients. Six patients had bilateral adrenalectomy. Two patients died during remission: one patient died from stroke two years after neurosurgery, and the other patient died due to surgery complications. During five-year follow-up after neurosurgery, remission continued in 76 (72.8%) patients, including 27 (77%) of 35 patients without MRI-detected adenoma and 49 (70%) of 70 patients with MRI-detected pituitary adenoma, p=0.15. Sixty-six patients developed recurrence, and 14 patients had active hypercortisolism. Conclusion. There was no correlation between the rate of preoperative MRI-based detection of pituitary adenoma and the rate of remission in neurosurgery patients with Cushing’s disease during the five year follow-up. The size of pituitary adenoma was a risk factor for adenoma recurrence.

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