Giant pituitary adenomas: clinical characteristics and surgical results

Although most pituitary neoplasms are benign, some grow rapidly, spreading to extrasellar tissues. Definition of these 'giant' pituitary adenomas (PAs) is not clear. In order to clarify this question, we studied all pituitary macroadenomas operated in our hospital during the last 20 years,...

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Bibliographic Details
Published in:British journal of neurosurgery 2002, Vol.16 (2), p.133-139
Main Authors: Garibi, J., Pomposo, I., Villar, G., Gaztambide, S.
Format: Article
Language:English
Subjects:
Adenoma
Adenoma - complications
Adenoma - pathology
Adenoma - surgery
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Clinical outcomes
Endocrinopathies
Female
Giant
Humans
Hypothalamus. Hypophysis. Epiphysis (diseases)
Male
Medical sciences
Middle Aged
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pituitary
Pituitary gland
Pituitary Neoplasms - complications
Pituitary Neoplasms - pathology
Pituitary Neoplasms - surgery
Prognosis
Results
Retrospective Studies
Sex Distribution
Surgery
Surgical
Treatment Outcome
Vision Disorders - etiology
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Summary:Although most pituitary neoplasms are benign, some grow rapidly, spreading to extrasellar tissues. Definition of these 'giant' pituitary adenomas (PAs) is not clear. In order to clarify this question, we studied all pituitary macroadenomas operated in our hospital during the last 20 years, differentiating those with diameter S 3 cm ( n = 43) and attempting to identify their typical features and prognosis. The reason for consultation was local in 58.3% of giant PAs, hormonal in 22.9% and tumour recurrence in 16.7%. Surgery was performed via a trans-sphenoidal approach in 92.5% of cases and succeeded in completely removing the tumour in only 27% of cases. In conclusion, we found that giant PAs are not a special type but the extreme case in the gradient of invasiveness of tumours of adenohypophyseal origin. They are characterized by a higher frequency of neuro-ophthalmological symptoms and hormonal deficits, and poorer response to surgical treatment.
ISSN:0268-8697
1360-046X
DOI:10.1080/02688690220131723