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Pituitary tumor: Presentation, diagnosis, and management using the transsphenoidal endoscopy

Januar Rizky Adriani, Nasrullah Mustamir, Prihantono Prihantono, Muhammad Faruk.


Abstract

Introduction: The pituitary tumor is the most common tumor found in the Sella region of the skull with varying prevalence. Although classified as benign, this tumor has a significant rate of morbidity and mortality. Case evaluation and disease courses require in determining therapy and prognosis for further cases.
Material and Methods: This retrospective descriptive study used data collection methods derived from the medical records of patients with pituitary tumors at three hospitals in Makassar, South Sulawesi. Data collection was carried out based on diagnosis, gender, chief complaints, head (Computerized Tomography) CT scan results, Magnetic Resonance Imaging (MRI) results, treatment, anatomic pathology results, and patient follow-up.
Results: The results showed five patients with pituitary adenoma who had the mean age of 45, three (60%) patients are male, and two (40%) are female. 20% patients with symptoms of endocrine disorders (acromegaly), and 80% patients with symptoms of the mass effect. Tumor size was measured volumetrically using the initial and the last follow-up MRI. We found that all detected masses were isointense with the most significant size 34 mm, the smallest size of 30 mm, and the mean previous tumor was 32 mm (SD = 1.79). All patients underwent transsphenoidal (TSS) procedures. 60% showed a significant improvement in visual field abnormalities and headaches after surgery. A second TSS surgery performed in 1 patient (20%) found to have tumor persistence.
Conclusions: TSS remains the treatment of choice for pituitary tumors. This study shows safe and effective TSS for pituitary tumors, provided surgeons with considerable experience and expertise perform it.

Key words: Acromegaly, Headache, Pituitary adenoma, Transsphenoidal surgery






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