The Clinical Study Of Tumor Residual And Recurrence Of Pituitary Microadenomas After Initial Transsphenoidal Surgery

IntroductionPituitary microadenoma is the benign tumor of anterior pituitarium, whose diameter is lesser than 10 millimeter. The incidence of pituitary adenoma is 11 cases per hundred, while the incidence of pituitary microadenoma is 10 percent of that of pituitary adenoma. Recent years, the study of pituitary microadenoma becomes hot as the incidence rises gradually. Transsphenoidal surgery is one of the major treatment. In the past, most studies were emphasized on the process and the healing effect of transsphenoidal surgery, while there were few studies focus on tumor residual and recurrence of pituitary microadenomas. The aim of this study were to evaluate tumor residual and tumor recurrence of pituitary microadenomas and to investigate factors which influence tumor residual, tumor recurrence.MethodsTo summarize 167 patients of pituitary microadenomas who underwent transsphenoidal surgery throng single nostril. To supervised the Magnetic Resonance Imaging (MRI) and endocrine evaluation in all patients before surgery,3,6,12 and 18 months after sugery. To analyze the relationships of tumor residual and tumor recurrence with their influencing factors using logistic regression.ResultsThere were 30 cases of tumor residual in 167 cases. The cases whose T2 weighing of MRI showed hypointense (p< 0.005) or isointense (p< 0.005) were prefer to occur tumor residual, as well as the cases that invaded cavernous sinus (p< 0.005) or suprasellar region (p< 0.05).There were two patients with tumor recurrence 12 months after transsphenoidal sugery, as well as 9 patients 18 months after transsphenoidal sugery. The cases of tumor residual were prefer to occur tumor recurrence (p< 0.05), as well as the cases that invaded cavernous sinus (p=0.005) or suprasellar region (p< 0.05). The cases with the ACTH microadenoma were also prefer to occur recurrence (p< 0.005).ConclusionsThe firm, fibrous pituitary microadenomas whose T2 weighing of MRI showed hypointense or isointense were prefer to occur tumor residual, as well as the ones that invaded cavernous sinus or suprasellar region. Thus, Determinant the consistency, location and shape of pituitary microadenoma must be done through careful study of MRI before transsphenoidal sugery. The pituitary microadenomas of tumor residual were prefer to occur tumor recurrence, as well as the ones that invaded cavernous sinus or suprasellar region. The ACTH microadenomas were also prefer to occur recurrence. And follow-up of those patients must be done regularly.