Giant pituitary adenomas: surgical outcome in a series of 127 cases

ABSTRACT

To analyze the surgical and visual outcome of giant pituitary adenomas. One-hundred-twenty-seven patients surgically treated over a 9-year period were studied. Fifty-four-point-three percent had non-functioning adenomas. Among the functioning adenomas, prolactinomas were the most common. A total of 90 transsphenoidal and 52 transcranial procedures were performed in 127 patients. The complications and deaths were significantly higher in the transcranial group. There were a total of 15 deaths [11.8%], Thirty-two-point-two percent had single/multiple postoperative complications. Vision improved in 49 patients [41.9%] at the time of discharge. Thirteen-point-eight percent of the pituitary adenomas are giant. Transsphenoidal surgery was the procedure of choice for most of the patients. These tumours represent a difficult group to treat. Prolactin estimation and preferably immunohistochemical analysis should be done in all patients in order to clinically diagnose indistinct prolactinomas