Presentation, management and outcomes of pituitary adenomas A 10-year experience from a single tertiary neurosurgery centre

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Bogdan Ionut David
Ligia Gabriela Tataranu
Vasile Gheorghe Ciubotaru
Aurelia Mihaela Sandu
Radu Mircea Gorgan

Abstract

Introduction: One of the most frequently encountered intracranial tumours are the pituitary adenomas, these accounting for 5% to 20%. Therapeutic strategies vary largely, from medical therapy to complex neurosurgical procedures. The transsphenoidal approach can solve most of the lesions of the pituitary area, as long as the invasion of the adjacent structures is not significant. The transcranial approach is indicated in tumours with extensive invasion


Materials and methods: We performed a retrospective study in the Bagdasar-Arseni Emergency Hospital Neurosurgery that aimed to analyze the demographics, signs and symptoms, therapeutic strategy, surgical approach, complications, and histopathology, from 2010 to 2019.


Results: The total number of hospitalization records, including the follow-up hospitalization and/or second surgery hospitalization, was of 1107. Furthermore, there were 704 unique patients. The most common signs and symptoms encountered for the first admission were headache (245 – 34.56%), optic chiasm deficits (153 – 21.58%), acromegaly (85 – 11.99%). However, the majority of patients (507 – 71.51%) presented with some sort of hormonal imbalance or diabetes insipidus. On the one hand, a number of 325 (45.84%) patients had non-surgical treatment. On the other hand, a total of 384 (54.16%) surgeries for pituitary tumours were performed in this period.


Discussion: In our study, the patients who underwent surgery benefited from either microsurgical transsphenoidal or transcranial surgeries. Even if the transsphenoidal approach was used far more, there was a greater relapse proportion in these patients. Transcranial surgery, even if followed by a far less proportion of relapse surgery, carried with it the burden of more days spent in hospital (most of the time twice as much as for the transsphenoidal patients).


Conclusion: Both transsphenoidal and transcranial approaches have advantages and disadvantages, thus the best strategy would be to tailor each surgery to each patient, keeping an open mind to all available approaches.

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How to Cite
David, B. I. ., Tataranu, L. G. ., Ciubotaru, V. G., Sandu, A. M., & Gorgan , R. M. . (2020). Presentation, management and outcomes of pituitary adenomas: A 10-year experience from a single tertiary neurosurgery centre. Romanian Neurosurgery, 34(2), 195-200. https://doi.org/10.33962/roneuro-2020-031
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Author Biographies

Bogdan Ionut David

PhD Student. University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania

 

Ligia Gabriela Tataranu

University of Medicine and Pharmacy “Carol Davilaˮ, Bucharest, Romania

Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania

Vasile Gheorghe Ciubotaru

Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania

Aurelia Mihaela Sandu

Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania

Radu Mircea Gorgan

1. University of Medicine and Pharmacy “Carol Davilaˮ, Bucharest, Romania

2. Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania