Determining need for treatment in residual pituitary adenomas.
OBJECTIVE
The optimal management of residual pituitary adenoma after resection is not clearly defined, with some authors proposing early radiosurgery or radiotherapy for patients with evidence of residual tumor on postoperative imaging and others recommending observation alone. This retrospective study seeks to determine the most appropriate treatment for patients with evidence of residual tumor on postoperative MRI.


METHODS
Forty-one consecutive patients who underwent transsphenoidal resection of pituitary adenomas between 2002 and 2005 and were followed radiographically and clinically for a mean of 4.4 years were analyzed.


RESULTS
Despite an official interpretation by a board-certified neuroradiologist suggesting the presence of residual tumor postoperatively in twenty-four out of forty-one patients, only four patients (16.7%) required additional intervention during the follow-up period. None of the patients received perioperative radiotherapy.


CONCLUSIONS
This suggests that aggressive management of radiographically suspected residual tumor may not be indicated and that observation with serial imaging may be sufficient in the management of patients with residual tumor.
Department of Neurosurgery, Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, USA - jsheehan@psu.edu.
G M
GM
Davies
C
C
Huang
J M
JM
Sheehan
D018450:Disease Progression; D006801:Humans; D018365:Neoplasm, Residual; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D057832:Watchful Waiting