Giant Pituitary Adenoma : Long-Term Outcome after Surgical Treatment of 61 Cases

Objective：The authors perform a retrospective analysis in order to evaluate long-term outcome results after surgical treatment of giant pituitary adenoma (PA) and to suggest the optimal treatment strategies. Methods : From 1990 to 2001, we experienced 61 cases of giant PA, the mean size was 4.8cm. The mean follow-up period was 47 months. There were 30 cases of functioning PA and 43 of invasive adenomas. Transsphenoidal approach (TSA) was performed in 47 patients, craniotomy in 6, and a staged operation (TSA followed by craniotomy) in 8. Gross total/near total removal (over 95% removal) was performed in 9 patients (TSA in 8 and craniotomy in one) and subtotal removal (over 50% and less than 95%) in the others. Post-operative radiotherapy (RTx) was performed in thirty-six patients. Treatment results were classified as controlled and non-controlled group. Controlled group was defined as patients with no evidence of mass growth, improvement of mass effect, and endocrinological normalization. Conclusion : Total removal of giant PAs through TSA or craniotomy is not always feasible and often risky. Subtotal resection of giant PAs by TSA with or without subsequent RTx may provide a good local tumor control. KCI Citation Count: 0