Treatment of nonfunctioning pituitary adenomas: what were the contributions of the last 10 years? A critical view.

摘要: Abstract Objectives .– All evidence for treatment and follow-up nonfunctioning pituitary adenomas (NFMA) is based on observational studies. The objective was to critically review the contributions of last 10 years NFMA. Materials methods Systematic review. Results Transsphenoidal surgery remains cornerstone When compared microsurgical procedure, some, but not all, studies favor endoscopy, endocrinological outcome different. Radiosurgery results in a high durable rate tumor control, including those previously treated by conventional radiotherapy, risk developing hypopituitarism comparable after radiotherapy. In selected patients without visual field defects, wait-and-see approach with frequent evaluation fields possible, irreversibly compromising function. Tumor progression NFMA difficult predict, MIB-1 LI clinically useful indicative invasiveness, does predict recurrence. To date, potential contribution other proliferation markers still requires further validation, effective medical strategies are available. New features role temozolomide rapamicin as therapeutical targets, combined octreotide. Although chimeric sst-DA analogues effectively inhibit vitro , effects these molecules have yet been evaluated clinical trials Conclusion Surgery, followed radiotherapy or radiosurgery case remnant recurrence, Currently, cannot be incorporated routine practice.