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Overview of Pituitary Tumors:

  • They account for about %10-%25 of brain tumors
  • Mean age of patients with pituitary tumors is 20-50 years.
  • Although symptoms largely depends on the type of the pituitary tumor, however, most patients present with headache.
  • Female patients are typically afflicted with Prolactin or ACTH secreting tumors and males with Growth hormone secreting tumors.
  • Depending on the different studies cited, they can be classified into 3 groups: benign, invasive adenoma, and carcinoma.
  • Adenomas form the largest portion of pituitary tumors with an overall estimated prevalence of about 17%, but only a minority are symptomatic.
  • Tumors less than 1 cm are classified as microadenoma and tumors equal or greater than 1 cm in size are called macroadenoma.  - Macroadenoma have a higher probability of causing visual field defects due to pressing on optic chiasm.
  • Prolactin secreting tumors are the most common pituitary tumors and respond well to non-surgical/medical treatment. 

 

Surgical Treament of Pituitary Tumors

Pituitary Tumors are approached by a team of surgeons composed of a Skull Based trained ENT surgeon and a Neurosurgeon.

 

After patients are seen and evaluated by each member of the Pituitary Tumor Team, patients' case is presented to the Eisenhower Brain Tumor Board and discussed.

 

Pituitary tumors are approached using modern neurosurgical technologies:

1- Neuroendoscopy

2- Microneurosurgery

3- Micro-doppler

4- Radiosurgery

5- Stereotactic Image Guidance

 

Dr. Limonadi and Dr. Ahsan performing a transphenoidal removal of a pituitary tumor at Eisenhower Medical Center.

 

 

 

 

Pituitary  tumor case presentation

  • 60-year-old lady who presented with headache. Endocrinological study revealed low TSH (thyroid stimulating hormone).  MRI scan of her brain revealed a pituitary tumor.

 

Tumor is outlined in a red dotted circle.

 

 

  • She underwent transphenoidal surgery using stereotactic image guidance, neuro-endoscopy, as well, as with utilization of surgical microscope.

 

 

The operating room in this case is equipped with Stealth stereotactic navigation, stereotactic neuro-endoscope, and surgical microsocope, providing accuracy with multiple views of the operating field.

 

 

The incision used was small as shown here (outlined in a red dotted circle).

 

She did well post operatively  and was discharged home in good health


 




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