Diagnosis and treatment of pituitary microadenoma: report of 80 cases.
OBJECTIVE
To analyse and discuss the diagnosis and treatment of pituitary microadenoma.


METHODS
Eighty cases of pituitary microadenoma treated with transsphenoidal approach in our department were analysed retrospectively during the last 2 years.


RESULTS
During following-up of 13.0+/-3.2 months, neither remained tumor was found except one patients with microprolactinoma, nor recurrence. Diabetes insipidus occurred in 19 patients, among which 15 patients recovered in 1 week, three in 1 month and one in 7 months. The adrenocorticotrophic hormone deficiency was found in nine of 63 patients with PRL-, GH- and non-functioning microadenoma (12%), but hypoadrenalemia recovered in all patients. Among these nine patients, seven recovered in 3 months and two in 6 months. Dysosphesia occurred in 32 cases: 30 recovered in 1 month and two in 4 months. Thirteen of 15 patients (86.7%) with ACTH-secreting microadenoma achieved chemical remission judged by plasma cortisol levels<or=2 microg/dl within 72 hours of surgery. During the mean 13.0 months of follow-up, the symptoms of amenorrhea, galactorrhea, headache, obesity and sexual disturbance were improved greatly. In total, 93.7% (45/48) of patients had normal post-operative PRL levels in the patients who had no pre-operative treatment history of long time medical therapy and large dose medical therapy in short time.


CONCLUSIONS
(1) Transsphenoidal surgery (TSS) is safe and effective treatment for pituitary microadenoma; (2) TSS is considered to be definitive treatment for ACTH- and GH-secreting microadenoma once the diagnosis is established; (3) in order to obtain better effects, TSS could be offered as first-line treatment for patients with locally non-invasive PRL-secreting microadenoma (tumor larger than 3 mm in diameter) and non-functioning microadenoma.
Zhang
Hong-Wei
HW
Department of Neurosurgery, Brain Sciences Institute of Beijing, and Fuxing Hospital affiliated to the Capital Medical University, Beijing 100038, China.
Sun
Wei
W
Yang
Jun
J
Yan
Chang-Xiang
CX
Yu
Chun-Jiang
CJ
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D011183:Postoperative Complications; D011388:Prolactin / Q000378:metabolism; D012189:Retrospective Studies
D000324:Adrenocorticotropic Hormone; D011388:Prolactin