Result of Surgical Management of Pituitary Tumor

ABSTRACT

The authors report results of surgical management in seventy-four cases of pituitary tumor who were treated in the department of neurosurgery, Keimyung University from Jan. 1987 to Dec. 1992. The composition of cases are prolactinoma in twenty-six cases, growth hormone(GH) secreting tumor in twenty, adrenocorticotropic hormone(ACTH) secreting tumor in three, thyrotropic hormone(TSH) secreting tumor in one and nonsecreting tumor in twenty-four cases. Fourty cases(54.1%) showed suprasellar and/or parasellar extension in the radiological studies. The modialites of management were surgery only in fourty-seven cases and surgery with radiation therapy in twenty-seven cases. Bromocriptin was medicated in twenty-two cases postoperatively. The management results in cases of prolactinoma, thirteen(50.0%) cases were cured and eight(30.8%) cases were improved. In the cases of GH secreting tumor, ten(50%) cases were cured and five(25%) cases were improved. Among three cases of ACTH secreting tumor, two cases were cured and there was one case of TSH secreting tumor which was cured. The worst management result were noticed in the cases of GH secreting tumor which extended suprasellar and/or parasellar region. of the thirty-five cases who had preoperative visual impairment(twenty-one cases of functional tumor and fourteen cases of nonfunctional tumor), twenty-seven(77.1%) cases were improved, sex(17.1%) cases not improved and two(5.7%) cases aggravated. The common complications after surgical management were hypopituitarism(eleven cases) and transient diabetes insipidus(nine cases). Recurrence was noticed in one case during follow-up period and three cases were expired, wtih one case during perioperative period and two during follow-up period. We conclude that an extensive effort should be made to diagnose early and advance surgical technique so as to improve the results of surgical management of the pituitary tumor.