Comparison Of The Patterns Of Extrasellar Extension Between GH Pituitary Macroadenomas And Non-GH Pituitarymacroadenomas

Purpose:During the course of diagnosis and curing of pituitary adenoma,we foundthat there were some difference in the patterns of growth to histopathologicalsubtype.Our purpose is to analyze the character of extrasellar extension betweenGH pituitary macroadenomas and non-GH pituitary macroadenomas,and then tounderstand the difference and common points of patterns of extrasellar extensionamong different styles of pituitary adenomas.Method:We analyze retrospectively the patients of pituitary adenomas who cameto BeiJing tiantan hospital between2008December and2013March for the cause ofheadache、 visual field defect or changes of face feature.All the patients gotexamination of preoperational CT and MRI on head and got confirmed by pathologyafter operation.It was excluded to microadenomas or patients who got operatedbefore.Then as a whole,we get patients histologically100confirmed GH-secretingmacroadenomas patients、32ACTH-secreting macroadenomas patients、53FSH-secreting macroadenomas patients、4LH-secreting macroadenomas patients、16TSH-secreting macroadenomas patients、46PRL-secreting macroadenomaspatients and50NFMAs patients.Preoperative CT images are performed on axial、coronal and sagittal plane,which were reviewed to assess the patterns in sella andbone damage in sella floor、anterior clinoid process and dorsum sella.PreoperativeMRI images are performed on normal scanning and contrast-enhanced axial、coronaland sagittal plane,which were reviewed to know about the size、pattern、extrasellarextension and the relationship with surrounding cavernous sinus and optic chiasm.Results:By comparison,we can get the results as follows:1、 No substantialdifference is found on sexual proportion between GH-secreting macroadenomaspatients and non-GH-secreting macroadenomas patients；2、The maximum meandiameter and mean volume of GH-secreting macroadenomas patients are smaller than non-GH-secreting macroadenomas patients；3、The patients with GH-secretingpituitary macroadenomas is younger than non-GH-secreting pituitary macroadenomaswhen they were diagnosed as pituitary adenomas for the first time；4、GH-macroadenomas demonstrated a proclivity for infrasellar extension, whereasnon-GH-secreting pituitary macroadenomas exhibited preferential extension into thesuprasellar region。5、There are no substantial differences between GH-secretingmacroadenomas with the others。6.Compared with GH-secretingmacroadenomas,NFMAs and FSH-secreting macroadenomas show a proclivity forinfrasellar extension,while when only consideration about isolated infrasellarextension,GH-secreting macroadenomas has more proclivity；7、When comparedwith the patterns itself,we can find that GH、ACTH、NFMAs and PRL-secretingmacroadenomas show a proclivity for infrasellar extension， while FSH-secretingmacroadenomas show a proclivity for infrasellar or supersellar extension,but LH andTSH-secreting macroadenomas has no statistical difference among differentdirections.Conclusion:There are substantial differences among different histologicalsubtypes of pituitary marcoadenomas in the patterns of extrasellar extension bycomparison of GH-secreting pituitary macroadenomas and non-GH-secretingpituitary macroadenomas.The patients with GH-secreting pituitary macroadenomasis younger than non-GH-secreting pituitary macroadenomas when they werediagnosed as pituitary adenomas for the first time,and also of the diameter andvolume of the tumor.Despite smaller tumor volume, GH-macroadenomasdemonstrated a proclivity for infrasellar extension, whereas non-GH-secretingpituitary macroadenomas exhibited preferential extension into the suprasellar region.