gms | German Medical Science

Objective: This is a retrospective study of patients who were treated for microadenomas between 2008 and 2012 at a single center. The objective was to determine remission and complication rates and complications.

Method: We conducted a retrospective data base research, focusing on diagnosis, early remission and surgery-related complications.

Results: 976 patients underwent transsphenoidal surgery for pituitary adenomas of various kinds. 333 patients were diagnosed as hormone-producing adenoma prior to the operation. 26 patients were diagnosed with microprolactinoma, with a primary remission rate of 92%, 39 patients were diagnosed with GH-producing microadenoma with a remission rate of 89% (in cases of primary operation) and 50% in cases of a secondary operation. Cushing’s disease was existent in 109 patients with remission rates of 92% in cases of primary therapy, 64% in cases of secondary and a remission rate of 60% in cases of tertiary surgical therapy. One patient underwent a fourth operation and did not go into remission after surgery. 5 patients were diagnosed with micro-TSHoma and had a remission rate of 100%. Epistaxis was the most common complication (n=9), followed by transient diabetes insipidus (n=7), SIADH (n=6) and partial anterior insufficiency (n=5), other complications such as complete pituitary insufficiency (n=1), sinusitis (n=1) and pulmonary embolism (n=1) were very uncommon. There was no mortality in surgery for microadenomas in this series.

Conclusions: High remission rates after surgery for microadenomas are achievable and present a realistic goal of transsphenoidal surgery, complications are mostly pituitary related and do usually not pose a major threat to the patients' health.