Summary
In 135 operated pituitary adenomas of different histological nature, seen over 20 years, the initial treatment was surgical, by transsphenoidal or transcranial approach depending on the tumour extent, followed by radiotherapy if necessary.
In spite of modern investigation methods, diagnosis is still often made late, so that 118 of our cases already had visual symptoms.
After surgery alone (87 cases) made by the same team recurrences occurred in 16%. Reoperations (14 cases) were generally more difficult and could also be followed by new recurrences needing finally radiotherapy with still positive results.
Two cases had initial radiotherapy, the other 46 cases were treated by surgery and radiotherapy with a recurrence level of 8,3%.
These results indicate the need to use immediate postoperative radiotherapy in every pituitary adenoma showing even the slightest invasive potential because radical surgery is hypothetical and recurrences possible. The recurrence of pituitary adenomas remains a difficult problem of anticipation and of curative management. Our position in terms of these benign tumours is to adopt readily this therapeutic course: surgery followed by radiotherapy, which provides the best prognosis without major risks.
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References
Aristizabal S, Caldwell WL, Avila J (1977) The relationship of time-dose fractionation factors to complications in the treatment of pituitary tumours by irradiation. Int J Radiât Oncol Biol Phys 2/7: 667–673.
Baskin DS, Boggan JE, Wilson CB (1982) Transsphenoidal microsurgical removal of growth hormone secreting pituitary adenomas. A review of 137 cases. J Neurosurg 56/5: 634–641.
Ciric IM, Mikhael T, Staford, Lawson L, Garces R (1983) Transsphenoidal microsurgery of pituitary macroadenomas with long term follow-up results. J Neurosurg 59: 395–401.
Ebersold MJ, Quast LM, Laws ER, Scheithauer B, Randall RV (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64/5: 713–719.
Fukamachi A, Tetsuo Wakado, Junichiro Akai (1982) Brain stem necrosis after irradiation of pituitary adenoma. Surg Neurol 18: 343–350.
Kern EB, Laws ER, Randall RV, Westwood WB (1977) A transseptal, transsphenoidal approach to the pituitary: an old approach. A new technique in the management of pituitary tumours and related disorders. Trans Am Acad Ophthalmol Otolaryngol 84/6: 997–1010.
Kern EB, Pearson BW, McDonaldt TJ, Laws ER (1979) The transseptal approach to lesions of the pituitary and parasellar regions. Laryngoscope 89/511 [Suppl] 15: 34 p.
Kunc Z (1977) Surgical problems in chromophobe adenomas. J Neurosurg Sci 21/2–3: 143–149.
Kutzner J (1983) Percutaneous radiotherapy in patients with pituitary tumours and recurrences. Therapiewoche 33/47: 6350–6352.
Martin WH, Cail WS, Morris JL, Constable WC (1980) Fibrosarcoma after high energy radiation therapy for pituitary adenoma. Am J Neuroradiol 1/5: 469–474.
Muhr C, Bergstrom K, Hugosson R, Lundberg PO (1980) Pituitary adenomas: computed tomography and clinical evaluation in a follow-up after surgical treatment. Neurol 19/3: 171–179.
Powell HC, Marshall LF, Ignelzi RJ (1977) Post irradiation pituitary sarcoma. Acta Neuropathol 39/2: 165–167.
Rubenstein R (1977) Treatment of pituitary microadenomas. Lancet 2/8035: 460.
Scheithauer BW, Kovacs KT, Laws ER, Randall RV (1986) Pathology of invasive pituitary tumours with special reference to functional classification. J Neurosurg 65/6: 733–744.
Shin H, Namba H, Ishigen N et al (1980) Pituitary fibrosarcoma secondary to radiation therapy for the treatment of chromophobe adenoma. Neurosurg 8/7: 605–614.
Symon L, Logue V, Mohanty S (1982) Recurrence of pituitary adenomas after transcranial operation. J Neurol Neurosurg Psychiatry 45/9: 780–785.
Wrightson P (1978) Conservative removal of small pituitary tumours: is it justified by the pathological findings. J Neurol Neurosurg Psychiatry 41/3: 283–289.
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© 1988 Springer-Verlag/Wien
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Vlahovitch, B., Reynaud, C., Rhiati, J., Mansour, H., Hammoud, F. (1988). Treatment and Recurrences in 135 Pituitary Adenomas. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_24
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DOI: https://doi.org/10.1007/978-3-7091-8975-7_24
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