ABSTRACT
Invasive pituitary adenomas have conventionally been treated with either no resection
or partial resection followed by radiation therapy. The long-term follow-up of this
subgroup of pituitary adenomas has not been satisfactory. The majority of these patients
present back with recurrence of their tumor or side effects related to treatment with
the radiation. The recent advances in surgical and skull base techniques have significantly
contributed to an improved outcome for these patients. We present a modified classification
for pituitary adenomas to account for the different types of invasive tumors based
on the molecular biological aspects as well as the clinical behavior of these tumors.
The treatment plan of invasive pituitary adenomas is influenced by the endocrinologic
aspects of the tumor cells, the neurological condition of patients at presentation,
the age of the patient, and the rate of tumor growth. In this article we present a
comprehensive treatment plan of invasive pituitary adenomas based upon the above-mentioned
parameters. The article also covers the most recent advances in skull base and microsurgical
techniques.
KEYWORDS
Invasive adenomas - surgical technique - pathophysiology - cavernous sinus
