Therapeutic strategy of giant pituitary adenomas

To retrospectively review clinical data of 32 giant pituitary adenomas and discuss the management of giant pituitary adenomas.Methods Among the 32 patients,17 cases were male and 15 were female.Mean age was 46.7 years old and mean history was 4.7 years.Tumor size was between 4 cm to 8 cm.Among them,one case was somatotrophic adenoma,6 were prolactinoma,and 25 were non-function adenomas.Twenty-four cases had transsphenoidal surgery,1 had trans-subfrontal craniotomy,6 had both transsphenoidal surgery and craniotomy,1 had only drug therapy.Results Under microscope,20 cases had total removal of tumor,9 had subtotal removal of tumor,and 2 had part removal of tumor.After surgery,10 cases had radiotherapy,and 5 had drug therapy.Postoperative follow-up were 6 months to 4 years.MRI showed 15 cases had total removal of tumor,14 had subtotal removal of tumor,and 2 had part removal of tumor.No case recurred.Conclusion In giant pituitary adenomas,the operative apporach should be decided according to the clinical manifestation,endocrinological results and growth characters of tumor.Transsphenoidal surgery is the first line therapy in most giant pituitary adenomas.Radiotherapy and drug therapy should be used in some invasive tumors.8 refs.