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Review
. 2022 Apr;55(2):351-379.
doi: 10.1016/j.otc.2021.12.008.

Giant Pituitary Adenoma - Special Considerations

Affiliations
Review

Giant Pituitary Adenoma - Special Considerations

Oliver Y Tang et al. Otolaryngol Clin North Am. 2022 Apr.

Abstract

Giant pituitary adenomas (GPAs) comprise 5% to 15% of pituitary adenomas, but have higher rates of extrasellar invasion, subtotal resection, surgical morbidity, and recurrence. With the possible exception of giant prolactinomas, GPAs require surgical decompression. On review of 3 decades of case series encompassing 699 microsurgical transsphenoidal (MT), 1060 endoscopic endonasal trans-sphenoidal (EET), and 513 transcranial (TC) patients, gross total resection and recurrence rates were comparable across modalities, but the EET approach had lower perioperative mortality and superior restoration of visual function. Each approach has unique indications. Combined EET-TC approaches for minimizing residual tumor represent another area of study.

Keywords: Endoscopic endonasal surgery; Microsurgery; Neurosurgery; Pituitary adenoma; Skull base; Transsphenoidal surgery; Tumor; Tumor outcomes.

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Conflict of interest statement

Disclosure The authors have nothing to disclose.