Long term follow-up of growth hormone-secreting pituitary adenomas submitted to endoscopic endonasal surgery

• Main Authors: Caroline Martins dos Santos Leopoldo, Felippe Martins dos Santos Leopoldo, Américo Rubens Leite dos Santos, José Carlos Esteves Veiga, José Viana Lima Junior, Nilza Maria Scalissi, Paulo Roberto Lazarini, Ricardo Landini Lutaif Dolci
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO)
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: acromegalia; adenoma hipofisário secretor de hormônio do crescimento; endoscopia
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000500301&lng=en&tlng=en

ABSTRACT Objective The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas. Methods A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.4ng/ml after glucose load and age-adjusted IGF-1 normal at the last follow-up. Results The overall endocrinological remission rate was 39.1%. While all microademonas achieved a cure, just one third of macroadenomas went into remission. Suprasellar extension, cavernous sinus invasion and high GH levels were associated with lower rates of disease control. The most common complication was diabetes insipidus and the most severe was an ischemic stroke. Conclusion The endoscopic transsphenoidal approach is a safe and effective technique to control GH-secreting adenomas. The transcavernous approach may increase the risk of complications. Suprasellar and cavernous sinus extensions may preclude gross total resection of these tumors.