Recurrent Pituitary Adenomas

摘要

The goals of treatment for all pituitary adenomas include: elimination of mass effect; normalization of hormonal hypersecretion; preservation of normal anterior and posterior pituitary function; and elimination of the potential for recurrence. Of all these goals, the last is the most difficult to achieve, and the management of recurrent pituitary adenomas is the focus of this presentation.Recurrences after surgical management may be related to incomplete removal of the lesion (technically, this is persistence of the tumor) or to recurrence of the basic disease process. Accurate estimates of post-surgical recurrence rates depend upon careful and complete follow-up studies. These include ophthahnological evaluations and determinations of baseline normal pituitary functions for those patients with clinically non-functioning pituitary tumors. These lesions are initially manifest by symptoms of mass effect - visual loss and hypopituitarism, and periodic follow-up studies help to show that the patient remains free of recurrent disease.