Analysis of Surgical Results of Pituitary Adenomas.

Kim, Jung Hoon; Kim, Chang Jin; Kwon, Yang; Rhim, Seung Chul; Lee, Jung Kyo; Kwun, Byung Duk; Whang, Chung Jin

Original Article

Journal of Korean Neurosurgical Society 1995;24(4): 383-394.

Jung Hoon Kim, Chang Jin Kim, Yang Kwon, Seung Chul Rhim, Jung Kyo Lee, Byung Duk Kwun, Chung Jin Whang

Department of Neurological Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.

ABSTRACT

From June, 1989 to December, 1993, 162 patients were diagnosed as a pituitary adenoma and treated by a surgical procedure. These patients were analyzed in terms of preoperative and postoperative hormonal level, grade, stage, size and treatment modalities. The results were as follows:1) The ratio of male versus female was 1:2.1. Female was predominant in twenties and thirties and male in forties. 2) The incidence of prolactinoma was 37.6% and non-functioning adenoma 37.1%, acromegaly 16.0%, Cushing's disease 5.6%. Marked female preponderence was noticed in prolactinoma and Cushing's disease. 3) The incidence of microadenoma in Cushing's disease was higher than the other tumor types. 4) The remission rate of prolactinoma was 54.1% and acromegaly 69.2%, Cushing's disease 66.7% and it was not correlated with tumor type. 5) Preoperative hormonal level was not correlated with grade, stage and size. 6) In prolactinoma, the remission rate was correlated with grade, stage, preoperative prolactin level, but not with size. 7) In acromegaly, the remission rate was correlated with grade, stage, but not with size and preoperative growth hormone level. 8) In Cushing's disease, the remission rate was not correlated with grade, stage, size and preoperative ACTH level. 9) The residual mass was noticed in 44.5% of patients and correlated with grade, stage and size. 10) The treatment modalities were surgery, surgery/bromocriptine, surgery/radiation therapy(including gamma knife surgery), surgery/bromocriptine/radiation therapy. Although surgery had the best treatment result, it had the lower preoperative hormonal level than the other treatment cases.