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Advances in surgical approaches for refractory pituitary adenomas

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Abstract

Refractory pituitary adenomas are difficult to control tumors that progress through optimal surgical, medical, and radiation management. Repeat surgery is a valuable tool to reduce tumor volume for more effective radiation and/or medical therapy, and to decompress critical neurovascular structures. Advances in surgical techniques and technologies, including minimally invasive cranial approaches, intraoperative MRI suites, and cranial nerve monitoring, have improved surgical outcomes and expanded indications. Today, repeat transsphenoidal surgery has similar complications rates to upfront surgery in historical cohorts. The decision to operate on refractory adenomas should be made with multidisciplinary teams, balancing the benefit of tumor reduction with the potential for complications, including cranial nerve injury, carotid injury, and cerebrospinal fluid leak.

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Authors and Affiliations

  1. Department Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, USA

    Matthew Pease & Viviane Tabar

  2. Department of Head and Neck Cancer, Memorial Sloan Kettering Cancer Center, New York, USA

    Marc A. Cohen

  3. Multidisciplinary Pituitary and Skull Base Tumor Center, Memorial Sloan Kettering Cancer Center, New York, USA

    Marc A. Cohen & Viviane Tabar

Authors
  1. Matthew Pease
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  2. Marc A. Cohen
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MP, MC, and VT prepared, edited, and reviewed the manuscript and figure.

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Correspondence to Matthew Pease.

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Pease, M., Cohen, M.A. & Tabar, V. Advances in surgical approaches for refractory pituitary adenomas. Pituitary 26, 293–297 (2023). https://doi.org/10.1007/s11102-023-01318-3

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