Giant pituitary adenoma: A cases report of 22

Document Type : Original


Assistant Professor, Department of Neurosurgery, Mashhad University of Medical Sciences


Introduction: Although most pituitary neoplasms are benign, but some of them spreads to extrasellar structures. Definition of these giant pituitary adenoma is not clear. In order to clarify this question, we studied all pituitary adenomas with diameter of 30 mm or more and attempting to identify their typical and clinical features, complications and their prognosis.
Material and Methods:  In our prospective study since 1996 to 2006, 235 patients had been admitted and operated in neurosurgical centers, were determind. We evaluated the clinical and paraclinical signs and symptoms and surgical results  of  these tumors and Rate of  recurrence, morbidity  and  mortality  was determind. Then we compared  these  results with  other  studies. The processing of the results was achieved by SPSS (11.5) and statistical analysis with descriptive methods.   
Results: From 235 patients with pituitary adenoma in our study, 131 patients were male and 104 cases were female. The age of patients were 18 to 75 years with the average of 50.5%. 22 patients from 234 cases had giant pituitary adenoma. The diameter of  their tumors were equal or more than 30 mm.The most common clinical findings in our patients with giant pituitary adenoma were visual impairement (95.4%), headache (81.8%), gait disturbance (13.6%), decreasing of libido (18.1%)  and  papilledema (27.2%). In our study, the most common giant pituitary adenomas were non-functional adenomas and prolactinomas respectively. Mortality and post operative complications
of giant pituitary adenomas is more than other adenomas.
Conclusions: The giant pituitary adenoma is about 10.6% of total pituitary adenomas. Although  these lesions  are not  special and typical   tumors  but  in  order to more invading and more  spreading  to adjacent structures, they are different of other adenomas. They are characterized by a higher clinical signs and symptoms, higher frequency of neuro-ophthalmological symptoms and  hormonal deficits  and poorer  response to surgical treatments. The rate of  recurrence,  morbidity  and  mortality is  more  than other  adenomas too.


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