Different imaging types and surgical treatment strategies of giant nonfunctioning pituitary adenomas
10.3760/cma.j.issn.1671-8925.2018.07.008
- VernacularTitle:巨大无功能性垂体腺瘤分型及外科治疗方式研究
- Author:
Jiaxing WANG
1
;
Liangfeng WEI
;
Jinhua XIE
;
Shuai ZHANG
;
Shun'an LIN
;
Lin ZHAO
;
Yinxing HUANG
;
Shousen WANG
Author Information
1. 厦门大学附属东方医院(福州总医院)神经外科
- Keywords:
Pituitary adenoma;
Image classification;
Microsurgery;
Treatment strategy
- From:
Chinese Journal of Neuromedicine
2018;17(7):692-698
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the therapeutic efficacy of giant nonfunctioning pituitary adenomas (GNPAs) of different imaging types,and to explore the surgical treatment strategies of GNPAs.Methods The pre-and post-operative images,clinical data and follow-up results of 69 patients with GNPAs,admitted to our hospital from July 2011 to October 2016,were analyzed retrospectively.According to the morphology and growth patterns of tumors on MR imaging,they were divided into GNPAs of vertical type,cystic type,deviation Ⅰ/Ⅱ type,lateral extension type,sinus type,laryngeal type,isolated type,and mixed type.The tumor resection results of GNPAs of different types were compared by different surgical treatment strategies.Results Fifty-one patients,with total resection rate of 31.37％,were treated by transsphenoidal approach,and 18 patients,total resection rate of 44.44％,were treated by craniotomy.The overall total resection rate of GNPAs was 36.23％ (n=25).Total resection rate and subtotal resection rate was 71.01％ (n=49).The surgery resection rates of GNPAs of different types were different,and the GNPAs of mixed type enjoyed the worst efficacy.Fifty-three patients were followed-up for one-66 months with an average of 17 months;in patients with total resection,18 (72％) were without recurrence,one (4％) was with recurrence;X knife treatment was performed in 14 patients.Postoperative residual reduction,control,and increase were noted in 4,26 and 4 patients.Two patients died after surgery.Conclusions The total reduction rate of GNPAs is low and the operation is difficult;however,favorable prognosis can be achieved.Transsphenoidal surgery is the first choice for elimination of occupying effect.According to different types,appropriate procedures can be used to reduce the tumor residue and improve the total resection or subtotal rates.
