Recurrent Adenomas
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About Recurrent Adenomas
General Information
- Pituitary adenomas that are not completely removed at the first operation will in many instances continue to grow and eventually require additional treatment.
- These tumors typically have invaded the structures around the pituitary, such as the dura mater covering over the brain, the sinus cavity and neighboring bone.
- Even in instances when the post-operative magnetic resonance imaging (MRI) scan or hormone studies suggest that the entire tumor was removed, tumors occasionally return within several years.
Treatment
- Treatment of recurrent adenomas involves additional surgery, medical therapy, radiotherapy or, in many instances, a combination of these therapies.
- For patients with functional pituitary tumors causing acromegaly, Cushing's disease or prolactinomas, medical therapies often are tried first, followed by radiation therapy.
- For individuals with endocrine-inactive adenomas, additional surgery, radiation or both are generally indicated.
- In patients who have relatively large and surgically accessible recurrent tumors, repeat transsphenoidal surgery is often the best treatment option.
Outcome
- Because of scarring associated with the first operation, repeat transsphenoidal surgery does carry a somewhat higher complication rate than initial transsphenoidal surgery. However, repeat transphenoidal surgery is generally safer than transcranial surgery, which involves opening a portion of the skull to reach the tumor.
- The endonasal transsphenoidal approach (surgery through one nostril) is particularly useful for patients who had a prior sublabial transsphenoidal surgery (surgery under the lip).
The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians.
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The UCLA Pituitary Tumor Program offers comprehensive management of adenomas