Recurrent non-functioning pituitary adenomas: a review on the new pathological classification, management guidelines and treatment options.

摘要: At least 50% of surgically resected non-functioning pituitary adenomas (NFPA) recur. Either early or late adjuvant radiotherapy is highly efficacious in controlling recurrent NFPA but associates potentially burdensome complications like hypopituitarism, vascular secondary neoplasm. Reoperation indicated bulky tumor rests compressing the optic pathway. To date, no standardized medical therapy available for although cabergoline and temozolomide show promising results. Guidelines on management NFPAs are now available. The new 2017 WHO classification, based immunohistochemistry transcription factor assessment, identifies a group aggressive variants that may benefit from earlier therapy. Nevertheless, patients exhibit reduced overall life expectancy largely due to hypopituitarism treatment-related morbidity. benefits multidisciplinary teamwork surgeons, endocrinologists, radiation oncologists, ophthalmologists, pathologists neuro-radiologists order provide individualized anticipate deterioration.