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Medical Management for Pituitary Adenoma Patients

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Transsphenoidal Surgery

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Abstract

Management of patients with pituitary adenomas undergoing transsphenoidal surgery requires an understanding of the various medical issues relevant to the preoperative, perioperative, and postoperative states. The identification and appropriate management of tumor-induced hypopituitarism can lessen the potential for operative complications; hypopituitarism itself can be a complication of surgery requiring long-term medical management to ensure optimal health for the patient. While transsphenoidal surgery functions as the preferred management strategy for many pituitary adenomas, medical therapy is effective for several types of clinically functioning adenomas. The high efficacy of medical therapy in treating prolactinomas is well established; surgery serves an adjunctive role in this condition. Medical therapy of acromegaly and Cushing’s disease is often utilized in the setting of persistent disease after surgery or while awaiting the therapeutic effect of radiation therapy to occur. While numerous medical options are available for treating both acromegaly and Cushing’s disease, the selection of a particular agent can be a challenging endeavor requiring a thorough knowledge of the risks and benefits of each medication. An understanding of the issues relevant to medical therapy of individuals undergoing transsphenoidal surgery is critical to providing optimal multidisciplinary care to this subset of patients.

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Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA

    Gregory K. Hong MD, PhD

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  1. Gregory K. Hong MD, PhD
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Correspondence to Gregory K. Hong MD, PhD .

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Editors and Affiliations

  1. Department of Neurosurgery, Harvard Medical School Brigham and Women’s Hospital, Boston, MA, USA

    Edward R. Laws, Jr

  2. Department of Neurosurgery, Indianapolis Methodist Hospital, Indianapolis, IN, USA

    Aaron A. Cohen-Gadol

  3. Department of Neurosurgery, Weill Cornell Medical College New York Presbyterian Hospital, New York, NY, USA

    Theodore H. Schwartz

  4. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA

    Jason P. Sheehan

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Hong, G.K. (2017). Medical Management for Pituitary Adenoma Patients. In: Laws, Jr, E.R., Cohen-Gadol, A.A., Schwartz, T.H., Sheehan, J.P. (eds) Transsphenoidal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-56691-7_21

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  • DOI: https://doi.org/10.1007/978-3-319-56691-7_21

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