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Review
. 2024 Nov;36(11):e13427.
doi: 10.1111/jne.13427. Epub 2024 Jul 4.

Advancement in perioperative management of pituitary adenomas-Current concepts and best practices

Ismat Shafiq  1 , Zoë R Williams  2 , G Edward Vates  3
Affiliations
Review

Advancement in perioperative management of pituitary adenomas-Current concepts and best practices

Ismat Shafiq et al. J Neuroendocrinol. 2024 Nov.

Abstract

Pituitary adenomas are very common representing 18.1% of all brain tumors and are the second most common brain pathology. Transsphenoidal surgery is the mainstay of treatment for all pituitary adenomas except for prolactinomas which are primarily treated medically with dopamine agonists. A thorough endocrine evaluation of pituitary adenoma preoperatively is crucial to identify hormonal compromise caused by the large sellar mass, identifying prolactin-producing tumors and comorbidities associated with Cushing and acromegaly to improve patient care and outcome. Transsphenoidal surgery is relatively safe in the hands of experienced surgeons, but still carries a substantial risk of causing hypopituitarism that required close follow-up in the immediate postoperative period to decrease mortality. A multidisciplinary team approach with endocrinologists, ophthalmologists, and neurosurgeons is the cornerstone in the perioperative management of pituitary adenomas.

Keywords: cortisol/corticosterone; perioperative; pituitary adenomas; prolactin; transphenoidal surgery.

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References

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