Treatment of functioning pituitary macroadenoma with endoscopic transsphenoidal surgery: a case report
https://doi.org/10.19106/JMedSci005304202109
Agusni Agusni
(1*) , Willy Adhimarta
(2) , Andi Asadul Islam
(3) , Djoko Widodo
(4) , Nasrullah Nasrullah
(5) , Andi Ihwan
(6) , Prihantono Prihantono
(7) , Muhammad Faruk
(8)
(1) Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(2) Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(3) Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(4) Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(5) Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(6) Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(7) Department of Surgery, Faculty of Medicine, Universitas Hasanuddin, Makassar
(8) Hasanuddin University, Makassar, Indonesia
(*) Corresponding Author
Abstract
Pituitary macroadenomas are benign tumors in the pituitary gland measuring more than 1 cm in diameter. Pituitary adenomas account for 8 to 10% of all intracranial tumors and occur primarily in the anterior pituitary lobe and rarely in the posterior lobe. Most pituitary macroadenomas are non-functioning tumors, which show clinical symptoms due to tumor pressure and do not increase hormonal activity. In this case, a 40 y.o. woman was diagnosed with a pituitary macroadenoma after showing clinical symptoms of a functioning tumor, namely acromegaly, prognathism, and large, beefy hands and feet, for the past 4 years. Complaints were accompanied by amenorrhea, intermittent cephalgia, and hemianopsia in the right eye. Blood laboratory tests revealed increased levels of prolactin and growth hormone, while the results of computed tomography (CT) scans and magnetic resonance imaging (MRI) of the head indicate the presence of a pituitary macroadenoma. Endoscopic transsphenoidal surgery, a minimally invasive procedure, was performed with minimal complications.
Keywords
endoscopic transsphenoidal surgery; pituitary macroadenoma; pituitary tumor; acromegaly; amenorrhea; sella turcica
References
Penar PL, Nathan DJ, Nathan MH, Salsali A. Pituitary tumor diagnosis and treatment. Curr Neurol Neurosci Rep 2002; 2(3):236-45. https://doi.org/10.1007/s11910-002-0082-6 Theodros D, Patel M, Ruzevick J, Lim M, Bettegowda C. Pituitary adenomas: historical perspective, surgical management and future directions. CNS Oncol 2015; 4(6):411-29. https:/doi.org/10.2217/cns.15.21 Adriani JR, Mustamir N, Prihantono P, Faruk M. Pituitary tumor: presentation, diagnosis, and management using the transsphenoidal endoscopy. Int J Med Rev Case Rep 2020; 4(4):50-5. https://doi.org/10.5455/IJMRCR.pituitary-tumour-management-dx Jane JAJ, Laws ERJ. The surgical management of pituitary adenomas in a series of 3,093 patients. J Am Coll Surg 2001; 193(6):651-9. https://doi.org/10.1016/s1072-7515(01)01101-2 McDowell BD, Wallace RB, Carnahan RM, Chrischilles EA, Lynch CF, Schlechte JA. Demographic differences in incidence for pituitary adenoma. Pituitary 2011; 14(1):23-30. https://doi.org/10.1007/s11102-010-0253-4 Wang F, Zhou T, Wei S, Meng X, Zhang J, Hou Y, et al. Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas. Surg Endosc 2015; 29(6):1270-80. https://doi.org/10.1007/s00464-014-3815-0 Cappabianca P, Cavallo LM, Colao A, Del Basso De Caro M, Esposito F, Cirillo S, et al. Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg 2002; 45(4):193-200. https://doi.org/10.1055/s-2002-36197 Gibbs IC, Tuniz F, Laws ER, Katznelson L. Pituitary Tumors. In: Hoppe RT, Phillips TL, Roach MBT-L and PT of RO (Third E, editors. Leibel and Phillips Textbook of Radiation Oncology. Third Edit. Philadelphia: W.B. Saunders; 2010. p. 477-86. Levy A. Pituitary disease: presentation, diagnosis, and management. J Neurol Neurosurg Psychiatry 2004; 75(suppl_3):iii47–52. https://doi.org/10.1136/jnnp.2004.045740 Stacey RJ, Powell MP. Sellar and Parasellar Tumors. In: Moore AJ, Newell DW, editors. Neurosurgery: Principles and Practice. London: Springer London; 2005. p.187-204. https://doi.org/10.1007/1-84628-051-6_11 Nomikos P, Ladar C, Fahlbusch R, Buchfelder M. Impact of primary surgery on pituitary function in patients with non-functioning pituitary adenomas ? A study on 721 patients. Acta Neurochir (Wien) 2004; 146(1):27-35. https://doi.org/10.1007/s00701-003-0174-3 Suh JH, Chao ST, Weil RJ. Pituitary Tumors. In: Gunderson LL, Tepper JEBT-CRO (Third E, editors. Clinical Radiation Oncology. 3rd Edit. Philadelphia: W.B. Saunders; 2012. p.493–509. https://www.sciencedirect.com/science/article/pii/B9781437716375000274 Abu Dabrh AM, Mohammed K, Asi N, Farah WH, Wang Z, Farah MH, et al. Surgical interventions and medical treatments in treatment-naïve patients with acromegaly: systematic review and meta-analysis. J Clin Endocrinol Metab 2014; 99(11):4003-14. https://doi.org/10.1210/jc.2014-2900 Blevins LS. Pituitary Tumors. In: Aminoff MJ, Daroff RBBT-E of the NS (Second E, editors. Oxford: Academic Press; 2014. p. 904–7. Available from: https://www.sciencedirect.com/science/article/pii/B9780123851574004917 Vargas G, Gonzalez B, Ramirez C, Ferreira A, Espinosa E, Mendoza V, et al. Clinical characteristics and treatment outcome of 485 patients with nonfunctioning pituitary macroadenomas. Int J Endocrinol 2015; 2015:756069. https://doi.org/10.1155/2015/756069 Rehman L, Rehman UL, Jabeen R, Rizvi R. Endoscopic trans-sphenoidal surgery; efficacy and response in pituitary adenoma. Pakistan J Med Sci 2018; 34(2):412-7. https://doi.org/10.12669/pjms.342.14002 Giustina A, Chanson P, Kleinberg D, Bronstein MD, Clemmons DR, Klibanski A, et al. Expert consensus document: A consensus on the medical treatment of acromegaly. Nat Rev Endocrinol 2014; 10(4):243-8. https://doi.org/10.1038/nrendo.2014.21 Gao Y, Zhong C, Wang Y, Xu S, Guo Y, Dai C, et al. Endoscopic versus microscopic transsphenoidal pituitary adenoma surgery: a meta-analysis. World J Surg Oncol 2014; 12(1):94. https://doi.org/10.1186/1477-7819-12-94 D’Haens J, Van Rompaey K, Stadnik T, Haentjens P, Poppe K, Velkeniers B. Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas. Surg Neurol 2009; 72(4):336-40. https://doi.org/10.1016/j.surneu.2009.04.012 Razak AA, Horridge M, Connolly DJ, Warren DJ, Mirza S, Muraleedharan V, et al. Comparison of endoscopic and microscopic trans-sphenoidal pituitary surgery: early results in a single centre. Br J Neurosurg 2013; 27(1):40-3. https://doi.org/10.3109/02688697.2012.703353 Goudakos JK, Markou KD, Georgalas C. Endoscopic versus microscopic trans-sphenoidal pituitary surgery: a systematic review and meta-analysis. Clin Otolaryngol 2011; 36(3):212-20. https://doi.org/10.1111/j.1749-4486.2011.02331.x
DOI:
https://doi.org/10.19106/JMedSci005304202109
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