Transsphenoidal Surgery for Mixed Pituitary Gangliocytoma-Adenomas.

Abstract:

BACKGROUND:Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare, with fewer than 100 cases reported in the literature to date and only 1 previously documented surgical series. Because MGAs are radiologically indistinguishable from pituitary adenomas, they are often diagnosed after surgery. Combined with the paucity of clinical outcome data for these tumors, this makes their diagnosis and management challenging. Here we describe the clinical presentation and outcomes of 10 individuals who were diagnosed with a MGA at a single institution. METHODS:This retrospective case series study included patients diagnosed with a combined sellar MGA between 1993 and 2016. RESULTS:This series comprised 10 patients, mean age of 44 years (range, 28-63 years) diagnosed with an MGA. The mean tumor size was 1.6 cm (range, 0.4-2.4 cm). Five patients presented with acromegaly, and 1 patient had recurrent Cushing disease. Transsphenoidal surgery was performed in all cases, and gross total resection was achieved in 7 patients (70%). Histologically, 9 of the 10 MGAs were identified as mixed somatotroph adenoma-gangliocytomas. The median duration of follow-up was 74 months (range, 2-180 months). Following adjuvant treatment (n = 3), all patients with acromegaly (n = 4) achieved biochemical remission, and no patient experienced recurrence of the pituitary tumor with a median radiographic follow-up of 48 months. CONCLUSIONS:MGAs are often associated with a hypersecretory adenoma. Transsphenoidal surgery is well tolerated by most patients, and when performed in combination with adjuvant therapy, a low rate of recurrence and reversal of preoperative endocrinopathy can be expected.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Shepard MJ,Elzoghby MA,Ghanim D,Lopes MBS,Jane JA Jr

doi

10.1016/j.wneu.2017.08.174

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

310-316

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)31484-5

journal_volume

108

pub_type

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