Diagnosis And Surgical Treatment Of Functional Pituitary Adenomas

ObjectiveThrough the clinical characteristics and biochemical indicators ofadolescence pituitary adenomas and GH pituitary adenomas to exploresituation of the diagnosis and treatment.MethodsThe clinical materials of36adolescent pituitary adenoma patientsand GH pituitary adenoma patients who were treated in our neurosurgerydepartment between April2003and June2013were retrospectivelyanalyzed, including their clinical features, endocrinology checks,imageological examinations, surgical treatments and postoperativecomplications.ResultAmong the36adolescent patients, there were8PRL adenomas,5GH adenomas,20ACTH adenomas and5non-function adenomas. All32patients were operated by transsphenoidal approach. Total resection wasachieved in35cases and subtotal resection in1case.24patients (66.67%)achieved biochemical remission. Total remission rate was57.1%of thepatient with GH adenoma. The obvious difference in remission rate wasfound between microadenomas and macroadenomas (P<0.001), invasive adenomas and noninvasive adenomas (P<0.001), several groups withdifferent preoperative GH level (P<0.05, respectively), intraoperativeGH level reduction>50%group and <30%group (P<0.01). There wasalso not obvious difference in group between intrasellar and extrasellar (P>0.05).There was not sharp difference in remission among1d afterpostoperative,1w after postoperative and1m after postoperative (P>0.05).ConclusionAdolescent pituitary adenomas could be certainly diagnosed byclinical features, endocrine examinations and imageological examinations.Transsphenoidal microsurgery is a major treatment for pituitary adenomain children and adolescents. For GH pituitary adenomas, the therapeuticoutcome is associated with the size, invasiveness of the tumors and thepreoperative level of GH. Preoperative and early postoperative GH levels(within1w and1month after surgery), and decline level of intraoperativeGH may predict clinical outcome in postsurgical management ofGH-secreting pituitary adenoma patients.