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Paper Information

Journal:   IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY   FALL 2007 , Volume 19 , Number 3 (49); Page(s) 151 To 156.


Author(s):  SAMINI F.*, FARAJI RAD M.
Introduction: Although most pituitary neoplasms are benign, but some of them spread to extrasellar structures. Definition of this giant pituitary adenoma is not clear. In order to clarify this question, we studied all pituitary adenomas with diameter of 30 mm or more and attempting to identify their typical and clinical features, complications and their prognosis.
Material and Methods: In our prospective study since 1996to 2006, 235 patients had been admitted and operated in neurosurgical centers, were determind. We evaluated the clinical and paraclinical signs and symptoms and surgical results of these tumors and Rate of recurrence, morbidity and mortality was determined. Then we compared these results with other studies. The processing of the results was achieved by SPSS (11.5) and statistical analysis with descriptive methods.
Results: From 235 patients with pituitary adenoma in our study, 131 patients were male and 104 cases were female. The age of patients was 18 to 75 years with the average of 50.5%. 22 patients from 234 cases had giant pituitary adenoma. The diameters of their tumors were equal or more than 30 mm. The most common clinical findings in our patients with giant pituitary adenoma were visual impairment (95.4%), headache (81.8%), gait disturbance (13.6%), decreasing of libido (18.1%) and papilledema (27.2%). In our study, the most common giant pituitary adenomas were non-functional adenomas and prolactinomas respectively. A mortality and post operative complication of giant pituitary adenomas is more than other adenomas.
Conclusions: The giant pituitary adenoma is about 10.6% of total pituitary adenomas. Although these lesions are not special and typical tumors but in order to more invading and more spreading to adjacent structures, they are different of other adenomas. They are characterized by a higher clinical signs and symptoms, higher frequency of neuro-ophthalmological symptoms and hormonal deficits and poorer response to surgical treatments. The rate of recurrence, morbidity and mortality is more than other adenomas too.
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