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. 1996 Jan;6(1):17–26. doi: 10.1055/s-2008-1058909

Microsurgical Management of Giant Pituitary Tumors

Wesley A King, Gerald E Rodts Jr, Donald P Becker, Duncan Q Mc Bride
PMCID: PMC1656511  PMID: 17170949

Abstract

Pituitary turnors with large suprasellar extensions are a difficult surgical challenge. A series of 11 patients with giant pituitary adenomas is reported. Seven men and four women (mean age 54.1 years). were diagnosed following a mean duration of symptoms of 60 months, Common presenting symptoms included visual disturbances, headache, personality changes, and panhypopituitarism. A single patient presented with rapid onset of coma and oculomotor nerve palsy. Eight patients underwent a transsphenoidal approach, and three patients underwent a craniotomy as the initial surgical procedure. A total of 16 surgical procedures were performed, resulting in complete or near complete resection in seven patients, and partial removal in four. Six patients had a good outcome and one patient in poor condition prior to surgery was unchanged postoperatively. One patient was worse following surgery, and there were two operative deaths. These tumors have a consistency and a propensity to adhere to neurovascular structures, making complete surgical resection difficult. Management should be individualized and should be based upon the radiographic and clinical features of the tumor. We feel that most leslons are best approached initially transsphenoidally, unless there is significant lateral extension. In many patients, aggressive surgery is not indicated and limited subtotal transsphenoidal resection followed by irradiation is recommended. Surgical decision making and strategy is discussed in relation to our recent experience with giant pitnitary adenomas.

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These references are in PubMed. This may not be the complete list of references from this article.

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