NEUROSURGICAL PERSPECTIVE ON NON-FUNCTIONING PITUITARY NEUROENDOCRINE TUMORS MANAGEMENT
| Autor: | Ligia Gabriela Tataranu, Vasile Ciubotaru, Adriana Solomon, Anica Dricu, Amira Kamel |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Romanian Neurosurgery, Vol 38, Iss Special Issue (2024) |
| Druh dokumentu: | article |
| ISSN: | 1220-8841 2344-4959 |
| DOI: | 10.33962/roneuro-2024-135 |
| Popis: | Introduction Pituitary Neuroendocrine Tumors (PitNETs), formerly designated as „pituitary adenomas” (PA), represent a relatively common pathology in the neurosurgical field, accounting for approximately 5.1 cases per 100,000 population yearly. The term “non-functioning” defines all PitNETs that do not induce a hormonal syndrome, and they account for up to 30%. Notwithstanding many aspects regarding non-functional PitNETs that are controversial, like the management of remnants or recurrences, the neurosurgical approach is indisputably indicated in cases of tumoral syndrome. Material and Methods The authors of this study aimed to assess patients presenting with non-functioning PitNETs and their outcomes after surgery in the 3rd Neurosurgical Department of the Clinical Emergency Hospital “Bagdasar-Arseni”, Bucharest, for a period of 8 years, between 2016 and 2023. This study is based on a thorough appraisal of the patient’s demographic and clinicopathological data while focusing on the strategic role of the neurosurgical approach. Results A total of 325 patients were identified with non-functioning PitNETs, that were treated in our department between the 1st of January 2016 and the 31st of March 2024, of which 193 (59.38%) were male and 132 (40.61%) were female. The mean age at admission was 50.70 years in the male group and 53.44 years in the female group, and the clinical manifestations were mostly those related to the tumoral mass effect, while more than half of the patients also presented with hypopituitarism. All of the patients included in this study underwent neurosurgery via a transnasal trans-sphenoidal approach and a gross-total resection was performed in 79% of cases (N=257). Surgical complications were described. Gamma-knife surgery was a postoperative neurosurgical option for 33 cases (48.5% of the patients with tumor remnants). Conclusion Non-functioning PitNETs usually have a slow development, which allows them to grow until the mass effect syndrome sends the patients to the doctor. Trans-sphenoidal surgery is greatly effective in providing symptomatic relief and if grosstotal resection is performed, the chances of recurrence are smaller. However, the intervention should be performed by a neurosurgeon with extensive experience in trans-sphenoidal surgery, to raise the odds of success and minimize the risks of complications. |
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