Transsphenoidal Microsurgery for Craniopharyngioma

2015 ◽  
pp. 426-429
Author(s):  
J�rgen Honegger ◽  
Rudolf Fahlbusch ◽  
Michael Buchfelder
Keyword(s):  
Transsphenoidal Microsurgery

The clinical and endocrine outcome after transsphenoidal microsurgery (TSm) of non secreting pituitary adenomas (NSPA)

1987 ◽  
Vol 28 ◽  
pp. 172
Author(s):  
H. Beauregard ◽  
R. Comtois ◽  
O. Serri ◽  
M. Somma ◽  
N. Jilwan ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Transsphenoidal Microsurgery

Short-term preoperative treatment of macroprolactinomas by dopamine agonists

1987 ◽  
Vol 67 (6) ◽  
pp. 807-815 ◽  
Author(s):  
Rudolf Fahlbusch ◽  
Michael Buchfelder ◽  
Uwe Schrell
Keyword(s):  
Dopamine Agonists ◽  
Low Dose ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Cystic Tumor ◽  
Preoperative Treatment ◽  
Short Term ◽  
Content Type ◽  
Transsphenoidal Microsurgery ◽  
Injectable Form

✓ During a period of 3 years, 25 patients with intra- and extrasellar macroprolactinomas were pretreated with dopamine agonists for a period of 2 to 6½ weeks prior to transsphenoidal microsurgical tumor resection. Dopamine agonists were administered orally to 17 patients, intramuscularly to three patients, and both orally and intramuscularly to five patients. Repeated computerized tomography (CT) examinations revealed that all neoplasms except one cystic tumor were reduced in size during the course of dopamine-agonist administration. No complications attributable to medical pretreatment were observed. Tumor shrinkage increased the efficacy of surgery, especially in cases with considerable extrasellar extension of the adenomas. Within 3 months following adenomectomy, prolactin levels were adjusted to normal levels in 19 patients by additional low-dose treatment with dopamine agonists. Thin-collimation CT assessments performed at least 3 months after surgery showed no evidence of residual tumor tissue in 23 patients. It is concluded that administration of dopamine agonists for some weeks prior to surgery is a useful adjunct to transsphenoidal microsurgery for macroprolactinomas. The new injectable form of bromocriptine is particularly valuable for this purpose.

Cushing's disease: results of transsphenoidal microsurgery with emphasis on surgical failures

1990 ◽  
Vol 72 (3) ◽  
pp. 363-369 ◽  
Author(s):  
George T. Tindall ◽  
Carl J. Herring ◽  
Richard V. Clark ◽  
David A. Adams ◽  
Nelson B. Watts
Keyword(s):  
Cushing’S Disease ◽  
Preoperative Diagnosis ◽  
Adrenocorticotropic Hormone ◽  
Remission Rate ◽  
Cushing's Disease ◽  
Sustained Remission ◽  
Original Diagnosis ◽  
Content Type ◽  
Transsphenoidal Microsurgery

✓ From 1977 to 1988, 56 patients with a preoperative diagnosis of Cushingαs disease were treated by transsphenoidal microsurgical exploration of the pituitary gland. In 42 patients, a discrete tumor was found and a selective adenomectomy was performed. Total hypophysectomy was performed in nine patients. In an attempt to preserve pituitary function, a technique of subtotal hypophysectomy was utilized in the remaining five patients. Regular and adequate follow-up results were obtained in 53 patients. A sustained remission was obtained in 45 of these 53 patients for a remission rate of 84.9%. Eight patients were classified as therapeutic failures. The causes for failure included: 1) invasive tumor; 2) hyperplasia mistaken for an adenoma; 3) a presumed ectopic source of adrenocorticotropic hormone; 4) misdiagnosis; 5) atypical tumor; and 6) recurrence of disease after remission. In cases of therapeutic failure, the original diagnosis of Cushing's disease must be reevaluated and treatment continued until sustained remission is achieved. Necessary measures to help avoid surgical failures and an approach for further diagnostic and therapeutic maneuvers in these cases are discussed.

Prolactin-Secreting Adenomas: Surgical Results and Long-Term Follow-up

Neurosurgery ◽  
1989 ◽  
Vol 24 (5) ◽  
pp. 736-743 ◽  
Author(s):  
Giulio Maira ◽  
Carmelo Anile ◽  
Laura De Marinis ◽  
Antonino Barbarino
Keyword(s):  
Empty Sella ◽  
Surgical Removal ◽  
Total Removal ◽  
Efficacious Treatment ◽  
Transsphenoidal Microsurgery ◽  
Long Term Follow Up ◽  
Grade Ii ◽  
Adenomatous Tissue

ABSTRACT Transsphenoidal surgery is an efficacious treatment for patients with prolactin (PRL)-secreting adenomas, even if disrupted pituitary-hypothalamic relationships may persist and/or a recurrence of the PRL-secreting tumor can occur. In this paper, we analyze the long-term follow-up of 119 consecutively treated women who underwent transsphenoidal microsurgery for PRL-secreting adenomas. Apparent total removal of the tumor was achieved in 98 patients who had enclosed tumors (58 with Grade-I tumors and 40 with Grade II). In the remaining patients, the removal was considered partial. Persistent normal basal PRL levels were achieved in 61 patients who had apparent total removal of the adenoma (44 with Grade I tumors and 17 with Grade II). Of the remaining 37 patients in whom surgical removal of the adenomatous tissue was thought to be total, 30 had persistent nonevolutive, high PRL levels ranging from 21 to 196 ng/ml, without clinical and radiological signs of tumor regrowth, and 7 with PRL levels ranging from 56 to 560 ng/ml had a recurrence of the PRL-secreting tumor. These data seem to indicate that a slightly elevated postsurgical PRL value does not imply that tumoral tissue is still present. Nontumoral conditions (i.e., a secondary empty sella) could induce functional hyperprolactinemia.

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