• World Neurosurg · Jan 2025

    A retrospective analysis of 338 surgically treated pituitary adenomas.

    • Xiaoyan Xu, Ruirui Liu, Xia Yang, Bin Bai, Qin Du, Yichun Wang, and Ping Liu.
    • Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
    • World Neurosurg. 2025 Jan 22: 123701123701.

    ObjectiveTo summarize the clinical characteristics, pituitary function assessment, postoperative pathological features, and postoperative recurrence of surgically treated pituitary adenomas (PAs).MethodsWe retrospectively reviewed the data of 338 patients (169 women; average age: 50.01 ± 12.47 years) who underwent surgical PA resection at our hospital during 2016-2020. Pathological PA classification was based on postoperative immunohistochemical staining for pituitary hormones. The clinical, imaging, laboratory, and follow-up data of the patients were statistically analyzed using SPSS v25.0.ResultsThe main complaints of PA patients were compressive symptoms, followed by endocrine symptoms; 23 tumors were incidentalomas. Compared with the 93 patients with functioning PAs, the 245 patients with non-functioning PAs were older, and had greater tumor diameters and rates of cavernous sinus invasion and pituitary apoplexy (P < 0.05). Postoperative hormonal staining most commonly revealed ACTH (27.4%) and FSH/LH positivity (20.6%); 23.1% of non-functioning tumors stained negative for pituitary hormones. Preoperative anterior hypopituitarism commonly involved the gonadal and thyroid axes, and was correlated with male sex and tumor diameter (P < 0.05). The optimal cut-off for tumor diameter was 1.95 cm for predicting preoperative hypopituitarism in patients with non-functioning PAs. The number of operations and preoperative hypopituitarism were correlated with postoperative pituitary dysfunction (P < 0.05). In the non-functioning PA group, tumor diameter was a risk factor for postoperative recurrence (optimal cutoff: 2.75 cm).ConclusionsThe management of patients with surgically treated PAs is limited by deficiencies in pathological classification, assessment of hypopituitarism, and detection of recurrence.Copyright © 2025. Published by Elsevier Inc.

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