REOPERATION VERSUS IRRADIATION IN CASES OF RECURRENT OR PERSISTENT GROWTH HORMONE SECRETING PITUITARY ADENOMA
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Keywords
Irradiation, Recurrent growth hormone, Acromegaly, Pituitary adenoma
Abstract
Background: Acromegaly is an uncommon disorder, with a prevalence of five to six patients for every one hundred thousand populations and an incidence of three to four for every million. The third most common intracranial neoplasm is pituitary adenomas which arise from adeno hypophysial cells of the anterior pituitary gland.
Aims and objectives: To identify the best option for treating recurrent and persistent acromegaly and evaluate the risks and advantages of each option.
Patients and methods: The study was conducted on operated cases with retrospectively collected follow-up data from 11 cases admitted to the Cairo University Hospitals in the period between March 2019 and April 2020 and 13 cases from the International Medical Center Cairo, Egypt, suffering from recurrent pituitary adenomas.
Results: There was a significant variance in age among the two groups (P = 0.015), but there was no significant variance among the two groups concerning type of adenoma (P = 0.123), pre-intervention GH mean levels among the two groups (P = 0.325), cavernous sinus affection between the two groups (P = 1.00), or outcome (P = 0.300).
Conclusion: In a carefully chosen group of acromegalic patients who had undergone prior operations at our center, both gamma knife stereotactic radiotherapy and sphenoidal surgery were effective and safe. While our study outcomes favor more trans-sphenoidal surgery over gamma knife stereotactic radiotherapy due to high rates of reduction of GH, less need for post-intervention treatment, and less time for achieving remission,
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Mohamed Ahmed Eissa
Department of Neurosurgery, Faculty of Medicine, Cairo University.
Amr El Samman
Department of Neurosurgery, Faculty of Medicine, Cairo University.
Ehab El Refaee
Department of Neurosurgery, Faculty of Medicine, Cairo University.
Mostafa Mohsen
Department of Neurosurgery, Faculty of Medicine, Cairo University.
Ayman Tarek Mahmoud
Department of Neurosurgery, Faculty of Medicine, Cairo University.