Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Giant and large pituitary adenomas (PA) constitute a specific subset of PAs, with gross total resection (GTR) rates frequently not exceeding 50%. Both an anatomical inaccessibility and an inadequate tumor visualization are thought to play a role. This study analyzes risk factors for postoperative residuals after endoscopic transsphenoidal pituitary surgery for large and giant pituitary adenomas.
Methods: A retrospective analysis of patients with giant and large PA operated between 2015 and 2018 was performed.
Results: Forty patients (13 females, 27 males) were included in the analysis (30 large and 10 giant PAs). The mean MRI follow-up time was 5.9 ± 6.54 months. Overall, GTR was achieved in 29 patients (72.5%), subtotal resection in 9 (22.5%), and the inconclusive result was in 2 (5%). Unexpected residuals represented 7 (77.7%) of all 9 residual tumors. The most frequent intraoperative factor associated with unexpected residual tumors was improper identification of residual tumor due to obstruction of view in 2 (28.5%) cases and inability to distinguish normal tissue from tumor in the other two (28.5%). Sub-analysis based on tumor size revealed that with large PAs, GTR was achieved in 25 (83.3%), STR in 4 (13.3%), and inconclusive in 1 (3.3%) patient. In patients with giant PAs, GTR was achieved in 4 (40%), STR in 5 (50%), and inconclusive in 1 (10%). Analysis of preoperative factors showed a significant association of residual tumors with larger suprasellar AP distance (p = 0.041), retrosellar extension (p = 0.007), and higher Zurich Score (p = 0.029).
Conclusion: Large and giant PAs are challenging lesions with high subtotal resection rates. Suprasellar AP distance, retrosellar extension, and higher Zurich Score seem to be significant predictors of degree of resection in these tumors. Improving the intraoperative ability to distinguish tumor from a normal tissue might further decrease the number of unexpected residuals.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00701-020-04497-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Boat noise alters behaviour of two coral reef macroinvertebrates, Lambis lambis and Tridacna maxima.
Mar Pollut Bull
September 2025
Marine Science Program, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Kingdom of Saudi Arabia.
Boat noise has been shown to distract and cause harm to many marine organisms. Most of the study effort has focused on fish & marine mammals, even though invertebrates represent over 92 % of all marine life. The few studies conducted on invertebrates have demonstrated clear negative effects of anthropogenic noise pollution.
View Article and Find Full Text PDFPlectin affects cell viscoelasticity at small and large deformations.
Biophys J
September 2025
Department of Bionanoscience and Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, 2629 HZ, The Netherlands. Electronic address:
Plectin is a giant protein of the plakin family that crosslinks the cytoskeleton of mammalian cells. It is expressed in virtually all tissues and its dysfunction is associated with various diseases such as skin blistering. There is evidence that plectin regulates the mechanical integrity of the cytoskeleton in diverse cell and tissue types.
View Article and Find Full Text PDFConservative Management of Giant Aneurysm of the Left Main to Left Circumflex Arteries.
JACC Case Rep
September 2025
Department of Cardiology, Dupuytren University Hospital, Limoges, France.
Background: Coronary artery aneurysm (CAA) is a rare congenital or acquired coronary malformation, associated with coronary artery fistula (CAF) in approximately 15% of cases. CAA is often asymptomatic.
Case Summary: We report the case of a 60-year-old woman diagnosed in 2017 with a 15-mm large giant left main to left circumflex CAA.
A multi-channel integrated auditory function test system.
Neuroscience
September 2025
Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China. Electronic address:
The auditory brainstem response (ABR) remains the gold standard for evaluating hearing function in both animal models and humans. Features of ABR, including threshold, wave I amplitude and latency are critical for diagnosing and investigating the mechanisms of hearing loss. Critically, the rapid proliferation of genetically engineered mouse models in hearing research has created an imperative demand for high-throughput ABR testing capabilities.
View Article and Find Full Text PDFA Rare Case of Giant Esophageal Leiomyoma in an Adult Male Presenting With Right Upper Quadrant Pain and Mild Dysphagia.
Cureus
August 2025
Medicine and Pediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Leiomyomas are the most common benign mesenchymal tumors of the esophagus, and they account for nearly two-thirds of benign esophageal neoplasms. The leiomyomas of the esophagus present with numerous nonspecific symptoms and signs, including dysphagia, shortness of breath, anorexia, weight loss, chronic cough, and bowel obstruction. The patient in this case report presented with moderate to severe right upper quadrant pain and mild dysphagia, which initially prompted evaluation for hepatobiliary pathology.
View Article and Find Full Text PDF