Analysis of adrenocorticotropic hormone secreting adenoma without early remission after transsphenoidal approach surgery
Feng Ming
Liu Xiaohai
Bao Xinjie
Deng Kan
Lian Wei
Xing Bing
Lu Lin
Zhu Huijuan
Pan Hui
Ma Wenbin
Yao Yong
Wang Renzhi
Abstract：Objective To analyze the diagnosis and treatment of adrenocorticotropic hormone (ACTH)-secreting adenoma (ACTH adenoma) without early postoperative remission. Methods The clinical data of 266 patients with ACTH adenoma by transsphenoidal surgery were analyzed retrospectively. There were 44 cases (16.5%) without early postoperative remission. There were primary ACTH adenoma in 34 patients (77.3%) and recurrent ACTH adenoma in 10 (22.7%). Positive MRI was seen in 30 patients (68.2%) and negative in 14 (31.8%). Pituitary microadenoma was found in 42 cases (95.5%) and pituitary macroadenoma in 2 (4.5%). Results The pathological results were pituitary adenoma in 25 cases (including 3 cases of atypical pituitary adenoma), pituitary hyperplasia in 6, anterior or posterior pituitary lobe in 13. All the patients were followed up for 12 to 36 months. The delayed remission was obtained in 3 patients, radiotherapy in 29 (including 25 cases of general radiotherapy, 4 of gamma knife), refusing treatment and receiving follow-up observation occurred in 2, death in 5 and loss to follow up in 5. In the radiotherapy, 11 patients' blood cortisol levels returned to normal, 2 patients underwent adrenalectomy because of poor radiotherapy efficacy. Conclusions For patients with ACTH adenoma who have no remission after surgery via transsphenoidal approach and after 6-month-follow-up, the best treatment could be chosen according to the individual patient's condition.
Keywords：pituitary neoplasmsadrenocorticotrophic hormonetranssphenoidal approach
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 197-200 )