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Giant non-functioning pituitary adenoma: clinical characteristics and therapeutic outcomes
dc.contributor.author | Iglesias, Pedro | |
dc.contributor.author | Arcano, Karina | |
dc.contributor.author | Triviño, Vanessa | |
dc.contributor.author | Guerrero-Pérez, Fernando | |
dc.contributor.author | Rodríguez Berrocal, Víctor | |
dc.contributor.author | Vior, Carlos | |
dc.contributor.author | Cordido, Fernando | |
dc.contributor.author | Villabona, Carles | |
dc.contributor.author | Díez, Juan J. | |
dc.date.accessioned | 2022-03-10T10:14:07Z | |
dc.date.available | 2022-03-10T10:14:07Z | |
dc.date.issued | 2020-01-02 | |
dc.identifier.citation | Iglesias P, Arcano K, Triviño V, Guerrero-Pérez F, Rodríguez Berrocal V, Vior C, et al. Giant non-functioning pituitary adenoma: clinical characteristics and therapeutic outcomes. Exp Clin Endocrinol Diabetes. 2021;129(4):309-313 | es_ES |
dc.identifier.issn | 0947-7349 | |
dc.identifier.uri | http://hdl.handle.net/2183/29943 | |
dc.description.abstract | [Abstract] Background: Giant pituitary adenoma (≥4 cm) is a rare tumor whose clinical features and prognosis are not well known. Aim: To evaluate the clinical characteristics and therapeutic outcomes of giant non-functioning PA (gNFPA). Patients and methods: A retrospective multicenter study of gNFPA patients diagnosed in a 12-year period was performed. In each patient, clinical data and therapeutic outcomes were registered. Results: Forty patients (24 men, age 54.2 ± 16.2 years) were studied. The maximum tumor diameter [median (interquartile range)] was 4.6 cm (4.1-5.1). Women had larger tumors [4.8 cm (4.2-5.4) vs. 4.5 cm (4.0-4.9); p=0.048]. Hypopituitarism [partial (n=22, 55%) or complete (n=9, 22.5%)] at diagnosis was present in 77.5% of the patients. Visual field defects were found in 90.9%. The most used surgical technique was endoscopic endonasal transsphenoidal (EET) surgery (n=31, 77.5%). Radiotherapy was used in 11 (27.5%) patients (median dose 50.4 Gy, range 50-54). Thirty-seven patients were followed for 36 months (10-67 months). Although more than half of these patients showed tumor persistence (n=25, 67.6%), tumor size was significantly reduced [0.8 cm (0-2.5); p<0.001]. At last visit, 12 patients (32.4%) showed absence of tumor on MRI. Hypopituitarism rate was similar (75.0%), although with significant changes (p<0.001) in the distribution of the type of hypopituitarism. The absence of tumor at the last visit was positively associated with positive immunohistochemical staining for FSH (p=0.01) and LH (p=0.006) and negatively with female sex (p=0.011), cavernous sinus invasion (p=0.005) and the presence of Knosp grade 4 (p=0.013). Conclusion: gNFPAs are more frequent in men but tumors are larger in women. Surgical treatment is followed by a complete tumor resection rate of approximately 30%. Positive immunostaining for gonadotropins is associated with tumor absence at last revision, while female sex and invasion of the cavernous sinuses with tumor persistence. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Thieme | es_ES |
dc.relation.uri | https://doi.org/10.1055/a-1017-3288 | es_ES |
dc.subject | Giant non-functioning pituitary adenoma | es_ES |
dc.subject | Hypopituitarism | es_ES |
dc.subject | Visual field defects | es_ES |
dc.subject | Neurosurgery | es_ES |
dc.subject | Therapeutic outcome | es_ES |
dc.title | Giant non-functioning pituitary adenoma: clinical characteristics and therapeutic outcomes | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.access | info:eu-repo/semantics/openAccess | es_ES |
UDC.journalTitle | Experimental and Clinical Endocrinology and Diabetes | es_ES |
UDC.volume | 129 | es_ES |
UDC.issue | 4 | es_ES |
UDC.startPage | 309 | es_ES |
UDC.endPage | 313 | es_ES |