title: Effect of gamma knife radiosurgery on a pituitary gonadotroph adenoma: a histologic, immunohistochemical and electron microscopic study.
abstract: The morphologic findings in a pituitary macroadenoma removed from a 65-year old man by the transsphenoidal approach 9 months after gamma knife surgery are reported. The tumor was immunoreactive for FSH beta and showed ultrastractural features consistent with an oncocytic gonadotroph adenoma. Accumulation of connective tissue separating small groups of adenoma cells was evident. Several dilated vessels and numerous vascular endothelial growth factor immunopositive adenoma cell were noted. By electron microscopy the endothelial linings frequently showed discontinuities with platelet accumulation attached to the gaps. Several vessels were severely injured showing necrosis of endothelial cells. It can be concluded that gamma knife surgery caused severe alterations in pituitary adenoma microcirculation indicating that vascular injury plays a crucial role in tumor shrinkage.
authors.affiliation: Department of Neurosurgery, Toranomon Hospital, Tokyo, Japan. syamadays11@hotmail.com
authors.forename: Shozo
authors.initials: S
authors.lastname: Yamada
authors.forename: Sergio
authors.initials: S
authors.lastname: Vidal
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sano
authors.forename: Eva
authors.initials: E
authors.lastname: Horvath
authors.forename: Kalman
authors.initials: K
authors.lastname: Kovacs
mesh_terms: D000236:Adenoma / Q000098:blood supply / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure*; D000368:Aged; D002196:Capillaries / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D009336:Necrosis; D010911:Pituitary Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure*; D016634:Radiosurgery; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A