Surgical treatment and follow-up results of pituitary ACTH microadenoma: 18 years' experience.

Abstract:

OBJECTIVE:To review retrospectively our clinical experience with surgical treatment and follow-up of pituitary adrenocorticotropic hormone (ACTH) microadenomas at Rui Jin Hospital of Shanghai Second Medical University. METHODS:Eighty-seven patients with ACTH microadenomas underwent surgery via the transsphenoidal approach. Preoperative computed tomography and/or magnetic resonance imaging revealed microadenomas in only 46 patients and was negative in the remaining 41 patients, which were classified as microadenoma grade 0. High-dose dexamethasone (Dx) suppression testing was positive in 86% of patients and low-dose Dx suppression testing was negative in all patients. RESULTS:Histological confirmation of ACTH microadenoma was made in all 87 cases, with a minimum tumour size of only 1 to 2 mm in diameter. The remission rate was 82% for grade I and 92% for grade 0 microadenomas during 2 to 18 years of follow-up. CONCLUSIONS:Neuroimaging studies have limited value in diagnosing ACTH grade 0 microadenoma. Clinical manifestation combined with positive Dx suppression testing is decisive in these circumstances. Surgical intervention could achieve a high relief rate for ACTH microadenomas, especially in grade 0 group.

journal_name

Asian J Surg

journal_title

Asian journal of surgery

authors

Zhao W,Zhan S,Cai Y,Shen J,Zhang T

doi

10.1016/S1015-9584(09)60210-4

keywords:

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

22-5

issue

1

eissn

1015-9584

issn

0219-3108

pii

S1015-9584(09)60210-4

journal_volume

26

pub_type

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