#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Pituitary Adenoma Therapy


Authors: D. Netuka;  V. Masopust;  V. Beneš
Authors‘ workplace: Neurochirurgická klinika 1. LF UK, IPVZ a ÚVN Praha
Published in: Cesk Slov Neurol N 2011; 74/107(3): 240-253
Category: Minimonography

Overview

Pituitary adenomas constitute 10–15% of intracranial tumours. These lesions are benign in the vast majority of cases. A combination of medical, neurosurgical and radiosurgical means is applied in treating them. A ‘watch-and-wait’ strategy is also a legitimate approach to treatment in certain cases. Only an appropriate combination of these modalities yields the best possible outcome. Close collaboration between endocrinologist, neurosurgeon and radiosurgeon is therefore essential. The endoscopic technique of pituitary adenoma resection is among the newer developments in surgical treatment, and intra-operative MR facilitates improved surgical results. This leads us to believe that intra-operative MR is indicated in surgery of sellar lesions. The goal of treatment is pituitary adenoma control, enabling the patient to live a normal life, of normal life expectancy, without hormonal substitution (whenever possible) and without visual impairment.

Key words:
pituitary adenoma – endocrinology – radiosurgery – endoscopy – intraoperative magnetic resonance imaging


Sources

1. Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML et al. The prevalence of pituitary adenomas: a systematic review. Cancer 2004; 101(3): 613–619.

2. Česák T, Náhlovský J, Látr I, Čáp J, Ryška P. Nádorová onemocnění hypofýzy. In: Náhlovský J (ed). Neurochirurgie. Praha: Galén 2006: 155–174.

3. Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space. A magnetic resonance imaging classification compared with surgical findings. Neurosurgery 1993; 33(4): 610–617.

4. Edal AL, Skjodt K, Nepper-Rasmussen HJ. SIPAP – a new MR classification for pituitary adenomas. Acta Radiologica 1997; 38(1): 30–36.

5. Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinomas. Pituitary 2005; 8(1): 3–6.

6. Mindermann T, Wilson CB. Age-related and gender-related occurrence of pituitary adenomas. Clin Endocrinol (Oxf) 1994; 41(3): 359–364.

7. Touraine P, Plu-Bureau G, Beji C, Maivais-Jarvis P, Kuttenn F. Long-term follow-up of 246 hyperprolactinemic patients. Acta Obstet Gynecol Scand 2001; 80(2): 162–168.

8. Colao A, Vitale G, Cappabianca P. Outcome of carbegoline treatment in men with prolactinoma: effects of a 24-month treatment on prolacin levels, tumor mass, recovery of pituitary function and semen analysis. J Clin Endocrinol Metab 2004; 89(4): 1704–1711.

9. Fleseriu M, Lee M, Pineyro MM, Skugor M, Reddy SK, Siraj ES et al. Giant invasive pituitary prolactinoma with falsely low serum prolactin: the significance of ‘hook effect’. J Neurooncol 2006; 79(1): 41–43.

10. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF. A comparison of cabergoline and bromcriptine in the treatment of hyperprolactineminic amenorrhea. N Engl J Med 1994; 331(14): 904–909.

11. Colao A, Di Sarno A, Sarnacchiaro S. Prolactinomas resistant to standard dopamine agonists to chronic cabergoline treatment. J Clin Endocrinol Metab 1997; 82(3): 876–873.

12. Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary 1999; 2(1): 29–41.

13. Orme SM, McNally RJ, Cartwright RA, Belchetz PE. Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom Acromegaly Study Group. J Clin Endoscrinol Metab 1998; 83(8): 2730–2734.

14. Giustina A, Barkan A, Casanueva FF. Criteria for cure of acromegaly: a consensus statement. J Clin Endoscrinol Metab 2000; 85(2): 526–529.

15. Freda PU, Reyes CM, Nuruzzaman AT, Sundeen RE, Khandji AG, Post KD. Cabergoline therapy of growth hormone and growth mormone/prolactin secreting pituitary tumors. Pituitary 2004; 7(1): 21–30.

16. Abs R, Verhelst J, Maiter D. Cabergoline in the treatment of acromegaly: a study in 64 patients. J Clin Endocrinol Metab 1998; 83(2): 374–378.

17. Caron P, Beckers A, Cullen DR. Efficacy of the new long-acting formulation of lanreotide (lanreotide autogel) in the management of acromegaly. J Clin Endocrinol Metab 2002; 87(1): 99–104.

18. Caron P, Cogne M, Raingeard I, Bex-Bachallerie V, Khun JM. Effectiveness and tolerability of 3-year lanreotide Autogel treatment in patients with acromegaly. Clin Endocrinol (Oxf) 2006; 64(2): 209–214.

19. Freda PU, Katznelson L, van der Lely AJ, Reyes CM, Zhao S, Rabinowitz D. Long-acting somatostatin analog therapy of acromegaly: a meta-analysis. J Clin Endocrinol Metab 2005; 90(8): 4465–4473.

20. Trainer PJ, Drake WM, Katznelson L. Treatment of acromegaly with growth hormone-receptor antagonist pegvisomant. N Eng J Med 2000; 342(16): 1171–1177.

21. Besser GM, Burman P, Daly AF. Predictors and rates of treatment-resistant tumor growth in acromegaly. Eur J Endocrinol 2005; 153(2): 187–193.

22. Colao A, Attanasio R, Pivonello R. Partial surgical removal of growth hormone secreting pituitary tumors enhances response to somatostatin analogs in acromegaly. J Clin Endocrinol Metab 2006; 91(1): 85–92.

23. Giustina A, Barkan A, Casanueva FF. Criteria for cure of acromegaly: a consensus statement. J Clin Endoscrinol Metab 2000: 85(2): 3417–3424.

24. Nomikos P, Buchfelder M, Fahlbusch R. Outcome of surgery in 668 patients with acromegaly using current criteria of biochemical “cure”. Eur J Endocrinol 2005; 152(3): 379–387.

25. Laws ER, Vance ML, Thapar K. Pituitary surgery for the management of acromegaly. Horm Res 2000; 53 (Suppl 3): 71–75.

26. Davis DH, Laws ER jr, Ilstrup DM. Results of surgical treatment for growth hormone-secreting pituitary adenomas. J Neurosurg 1993; 79(1): 70–75.

27. Freda PU. How effective are current therapies for acromegaly? Growth Horm IGF Res 2003; 13 (Suppl A): S144–S151.

28. Jezková J, Marek J, Hána V, Krsek M, Weiss V, Vladyka V et al. Gamma knife radiosurgery for acromegaly – long-term experience. Clin Endocrinol (Oxf) 2006; 64(5): 588–595.

29. Findling JW, Raff H. Screening and diagnosis of Cushing’s syndrome. Endocrinol Metab Clin N Am 2005; 34(2): 341–356.

30. Findling JW, Raff H. Cushing’s syndrome: important issues in diagnosis and management. J Clin Endocrinol Metab 2006; 91(10): 3746–3753.

31. Arnaldi G, Angeli A, Atkinson AB. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab 2003; 88(12): 5593–5602.

32. Aron DC, Raff H, Findling JW. Effectiveness versus efficacy: The limited value in clinical practise of high dose dexamethasone suppression testing in the differential diagnosis of adrenocorticotrophin-dependend Cushing’s syndrome. J Clin Endocrinol Metab 1997; 82(6): 1780–1785.

33. Tabarin A, Laurent F, Catargi B. Comparative evaluation of conventional and dynamic magnetic resonance imaging of the pituitary glang for the diagnosis of of Cushing’s dinase. Clin Endocrinol (Oxf) 1998; 49(3): 293–300.

34. Patronas N, Bulakbasi N, Stratakis CA. Spoiled gradient recalled acquisition in the steady state technique is superior to conventional postcontrast spin echo technique for magnetic resonance imaging detection of adrenocorticotrophin-secreting pituitary tumors. J Clin Endocrinol Metab 2003; 88(4): 1565–1569.

35. Hall WA, Luciano MG, Doppman JL, Patronas NJ, Oldfield EH. Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med 1994; 120(10): 817–820.

36. Kelly DF. Cushing’s disease: Surgical Management. In: Swearingen B, Biller BMK (eds). Diagnosis and Management of pituitary disorders. Totowa, NJ: Humana Press 2008: 203–222.

37. Sheehan JM, Vance ML, Sheehan JP. Radiosurgery for Cushing’s disease after failed transsphenoidal surgery. J Neurosurg 2000; 93(5): 738–742.

38. Sonino N, Zielezny M, Fava GA. Risk factors and long-term outcome in pituitary-dependent Cushing’s disease. J Clin Endocrinol Metab 1996; 81(7): 2647–2652.

39. Smallridge RC. Thyrotropin-secreting pituitary tumors. Endocrinol Metab Clin North AM 1987; 16(3): 765–792.

40. Katznelson L, Alexander JM, Klibanski A. Clinical review 45: Clinically nonfunctioning pituitary adenomas. J Clin Endoscrinol Metab 1993; 76(5): 1089–1094.

41. Shimon I, Melmed S. Management of pituitary tumors Ann Intern Med 1998; 129(6): 472–483.

42. Česák T, Náhlovský J, Hosszú T, Řehák S, Látr I, Němeček S et al. Longitudinální sledování růstu pooperačních reziduí afunkčních adenomů hypofýzy. Cesk Slov Neurol N 2009; 75/105(2): 115–124.

43. DeLellis RA, Lloyd RV, Heitz PU, Eng C. Pathology and Genetics of Tumours of Endocrine Organs, WHO Classification of Tumours. Lyon: IARC Press 2004.

44. Pernicone PJ, Scheithauer BW, Sebo TJ. Pituitary carcinoma: a clinicopathologic study of 15 cases. Cancer 1997; 79(4): 804–812.

45. Ulmer S, Byrne TN. Lymphocytic Hypophysitis adn Inflammatory Disease of the Pituitary. In: Swearingen B, Biller BMK (eds). Diagnosis and Management of pituitary disorders. Totowa, NJ: Humana Press 2008: 339–352.

46. Bailey P. Pathological report of a case of acromegaly, with special reference to the lesions in the hypophysis cerebri and in the thyroid gland; and of a case of hemorrhage into the pituitary. Philadelphia Med J 1898; 1(18): 789–792.

47. Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA. Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf) 1999; 51(2): 181–188.

48. Molitch ME, Russell EJ. The pituitary “incidentaloma”. Ann Intern Med 1990; 112(12): 925–931.

49. Hall WA, Luciano MG, Doppman JL, Patronas NJ, Oldfield EH. Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med 1994; 120(10): 817–820.

50. Oyama K, Sanno N, Tahara S, Teramoto A. Management of pituitary incidentalomas: according to survey of pituitary incidentalomas in Japan. Semin Ultrasound CT MR 2005; 26(1): 47–50.

51. Lindholm J. A century of pituitary surgery: Schloffer’s legacy. Neurosurgery 2007; 61(4): 865–867.

52. Cohen-Gadol AA, Liu JK, Laws ER jr. Cushing’s first case of transsphenoidal surgery: the launch of the pituitary surgery era. J Neurosurg 2005; 103(3): 570–574.

53. Liu JK, Das K, Weiss MH, Laws ER jr, Couldwell WT. The history and evolution of transsphenoidal surgery. J Neurosurg 2001; 95(6): 1083–1096.

54. 50 let Neurochirurgické kliniky v Hradci Králové: almanach k 50. výročí založení neurochirurgické kliniky v Hradci Králové. Hradec Králové: Zetka 2002: 31.

55. Fusek I, Černý E. Transsphenoidal operation of hypophyseal tumors. J Neurosurg Sci 1977; 21, 159–160.

56. Fusek I, Černý E. Naše zkušenosti s indikacemi transsfenoidálních operací nádorů tureckého sedla. Cesk Slov Neurol N 1978; 41/74: 107–114.

57. Hirsch O. Endonasal method of removal hypophyseal tumors. JAMA 1910; 55(9): 772–774.

58. Griffith HB, Veerapen R. A direct transnasal approach to the sfenoid sinus. Technical note. J Neurosurg 1987; 66(1): 140–142.

59. Stammberger H. Endoscopic endonasal surgery – Concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg 1986; 94(2): 147–156.

60. Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M. Endoscopic pituitary tumor surgery. Laryngoscope 1992; 102(2): 198–202.

61. Sethi DS, Pillay PK. Endoscopic management of lesions of the sella turcica. J Laryngol Otol 1995; 109(10): 956–962.

62. Carrau RL, Jho HD, Ko Y. Transnasal-transsphenoidal endoscopic surgery of the pituitary gland. Laryngoscope 1996; 106(7): 914–918.

63. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: Experience with 50 patients. J Neurosurg 1997; 87(1): 44–51.

64. Rodziewicz GS, Kelly RT, Kellman RM, Smith MV. Transnasal endoscopic surgery of the pituitary gland: Technical note. Neurosurgery 1996; 39(1): 189–193.

65. Cappabianca P, Alfieri A, de Divitiis E. Endoscopic endonasal transsphenoidal approach to the sella: Towards functional endoscopic pituitary surgery (FEPS). Minim Invas Neurosurg 1998; 41(2): 66–73.

66. Masopust V, Netuka D, Beneš V. Endonazální endoskopická transsfenoidální resekce selárních lézí. Cesk Slov Neurol N 2008; 71/104(6): 704–710.

67. Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurg Focus 2005; 19(1): E3.

68. Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus 2005; 19(1): E4.

69. Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R. Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus 2005; 19(1): E6.

70. de Almeida JR, Snyderman CH, Gardner PA, Carrau RL, Vescan AD. Nasal morbidity following endoscopic skull base surgery: A prospective cohort study. Head Neck 2010; 33(4): 547–551.

71. Pant H, Bhatki AM, Snyderman CH, Vescan AD, Carrau RL, Gardner P et al. Quality of life following endonasal skull base surgery. Skull Base 2010; 20(1): 35–40.

72. Dusick JR, Esposito F, Mattozo CA, Chaloner C, McArthur DL, Kelly DF. Endonasal transsphenoidal surgery: the patient‘s perspective-survey results from 259 patients. Surg Neurol 2006; 65(4): 332–341.

73. Ludecke DK, Abe T. Transsphenoidal microsurgery for newly diagnosed acromegaly: a personal view after more than 1,000 operations. Neuroendocrinology 2006; 83(3–4): 230–239.

74. Nimsky C, von Keller B, Ganslandt O, Fahlbusch R. Intraoperative high-field magnetic resonance imaging in transsphenoidal surgery of hormonally inactive pituitary macroadenomas. Neurosurgery 2006; 59(1): 105–114.

75. Shou XF, Li SQ, Wang YF, Zhao Y, Jia PF, Zhou LF. Treatment of pituitary adenomas with a transsphenoidal approach. Neurosurgery 2005; 56(2): 249–256.

76. Náhlovský J, Česák J, Látr I, Čáp J, Žižka J, Krajina A. Komplikace transsfenoidálních operací u našich nemocných – příčiny, řešení. Cesk Slov Neurol N 2004; 67/100(2): 112–119.

77. Sameš M, Vachata P, Saur K, Budíková M. Přímý transnazální miniinvazivní přístup pro mikrochirurgickou resekci adenomů hypofýzy. Cesk Slov Neurol N 2005; 68/101(5): 337–341.

78. Jho H. Endoscopic endonasal approach to the optic nerve: a technical note. Minim Invasive Neurosurg 2001; 44(4): 190–193.

79. Dusick JR, Esposito F, Kelly DF. The extended direct endonasal transsphenoidal approach for nonadenomatous suprasellar tumors. J Neurosurg 2005; 102(5): 825–827.

80. Cavallo LM, Prevedello DM, Solari D, Gardner PA, Esposito F, Snyderman CH et al. Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas. J Neurosurg 2009; 111(3): 578–589.

81. Horsley V. On the technique of operations on the central nervous system. Br Med J 1906; 2: 411–423.

82. Krause F. Freilegung der hypofyse. In: Krause F (ed). Die allgemeine Chirurgie der Gehirnkrankheiten, Part II. Suttgart: Ferdinand Enke 1914: 465–470.

83. McArthur LL. An aseptic surgical approach to the pituitary body and its neighborhood. JAMA 1912; 58: 2009–2011.

84. Frazier CH. Lesions of the hypophysis from the viewpoint of the surgeon. Surg Gyn Obst 1913; 17: 724–736.

85. Heuer GJ. Surgical experiences with an intracranial approach to chiasmal lesions. Arch Surg 1920; 1: 368–381.

86. Gerlach R, du Mesnil de Rochemont R, Gasser T, Marquardt G, Reusch J, Imoehl L et al. Feasibility of Polestar N20, an ultra-low-field intraoperative magnetic resonance imaging system in resection control of pituitary macroadenomas: lessons learned from the first 40 cases. Neurosurgery 2008; 63(2): 272–284.

87. Hadani M, Spiegelman R, Feldman Z, Berkenstadt H, Ram Z. Novel, compact, intraoperative magnetic resonance imaging-guided system for conventional neurosurgical operating rooms. Neurosurgery 2001; 48(4): 799–807.

88. Hall WA, Liu H, Martin AJ, Pozza CH, Maxwell RE, Truwit CL. Safety, efficacy, and functionality of high-field strength interventional magnetic resonance imaging for neurosurgery. Neurosurgery 2000; 46(3): 632–641.

89. Jankovski A, Raftopoulos C, Vaz G, Hermoye L, Cosnard G, Francotte F et al. Intra-operative MR at 3T: short report. JBR-BTR 2007; 90(4): 249–251.

90. Sutherland GR, Kaibara T, Louw D, Hoult DI, Tomanek B, Saunders J. A mobile high-field magnetic resonance system for neurosurgery. J Neurosurg 1999; 91(5): 804–813.

91. Martin CH, Schwartz R, Jolesz F, Black PM. Transsphenoidal resection of pituitary adenomas in an intraoperative MR unit. Pituitary 1999; 2(2): 155–162.

92. Nimsky C, Ganslandt O, Von Keller B, Romstöck J, Fahlbusch R. Intraoperative high-field-strength MR imaging: implementation and experience in 200 patients. Radiology 2004; 233(1): 67–78.

93. Fahlbusch R, Keller B, Ganslandt O, Kreutzer J, Nimsky C. Transsphenoidal surgery in acromegaly investigated by intraoperative high-field magnetic resonance imaging. Eur J Endocrinol 2005; 153(2): 239–248.

94. Nimsky C, von Keller B, Ganslandt O, Fahlbusch R. Intraoperative high-field magnetic resonance imaging in transsphenoidal surgery of hormonally inactive pituitary macroadenomas. Neurosurgery 2006; 59(1): 105–114.

95. Jones J, Ruge J. Intraoperative magnetic resonance imaging in pituitary macroadenoma surgery: an assessment of visual outcome. Neurosurg Focus 2007; 23(5): E12.

96. Netuka D, Masopust V, Belšán T, Kramář F, Beneš V. One year experience with 3.0 T intraoperative MRI in pituitary surgery. Acta Neurochir Suppl 2011; 109: 157–159.

97. Netuka D, Masopust V, Belšán T, Kramář F, Beneš V. První zkušenosti s použitím intraoperační MR při operacích adenomů hypofýzy. Cesk Slov Neurol N 2009; 72/105(1): 45–50.

98. Sheehan JP, Niranjan A, Sheehan JM. Sterotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical armamentarium. J Neurosurg 2005; 102(4): 678–691.

99. Liscák R, Vladyka V, Marek J, Simonová G, Vymazal J. Gamma knife radiosurgery for endocrine-inactive pituitary adenomas. Acta Neurochir (Wien) 2007; 149(10): 999–1006.

100. Jezková J, Hána V, Krsek M, Weiss V, Vladyka V, Liscák R et al. Use of the Leksell gamma knife in the treatment of prolactinoma patients. Clin Endocrinol (Oxf) 2009; 70(5): 732–741.

101. Marek J, Jezková J, Hána V, Krsek M, Bandúrová L, Pecen L et al. Is it possible to avoid hypopituitarism after irradiation of pituitary adenomas by the Leksell gamma knife? Eur J Endocrinol 2011; 164(2): 169–178.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 3

2011 Issue 3

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#