CC-BY-NC-ND 4.0 · IJNS 2017; 06(03): 176-183
DOI: 10.1055/s-0037-1598091
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Evaluation of Factors Affecting Outcome in Growth Hormone–Secreting Pituitary Adenomas

Amit Padwal
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
,
Jagath Lal Gangadharan
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
,
Dwarakanath Srinivas
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
,
Sampath Somanna
Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
› Author Affiliations
Further Information

Publication History

21 July 2016

18 October 2016

Publication Date:
22 September 2017 (eFirst)

Abstract

Introduction Management of functioning pituitary adenomas is challenging as they can present with features of an intracranial mass, systemic effects, or a combination of both. In this series, one of the largest in available literature from our country, we have analyzed our experience with surgical management of growth hormone (GH)-secreting pituitary adenomas and factors influencing their hormonal remission.

Materials and Methods The data of all functional pituitary adenomas operated at our institute from January 2002 to December 2011 were obtained from the case files of these patients. This was studied for various clinical-radiologic features, management stratagems, and clinical and hormonal outcomes.

Results Ninety-three patients of GH-secreting pituitary adenomas with a mean age of 32.7 years were included in the study. Fifty-three (57%) patients had headache at presentation; 46 (49%) had visual complaints, whereas menstrual irregularity was seen in majority of females. Mean GH level was 52.05 ng/mL. Fifty (53%) patients had invasive adenoma; 32 had cavernous sinus extension. Among 80 patients with hormonal follow-up, 43 (53.75%) achieved remission of GH level < 5 ng/mL.

Conclusion In this series, one of the largest of its kind, the main factors influencing unfavorable outcome include macroadenomas, invasiveness, high basal GH > 45 ng/mL levels, and mixed adenomas.