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首页> 外文期刊>Neurosurgical focus >Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas
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Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas

机译：生长激素分泌和非功能性垂体大腺瘤的鞍外延伸模式

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Object. Growth patterns of pituitary adenomas have been observed to vary by histopathological subtype. The authors aimed to analyze variations in the patterns of extrasellar extension of nonfunctional macroadenomas (NFMAs) and growth hormone (GH)-secreting macroadenomas.Methods. A retrospective review was conducted of data obtained in 75 patients who underwent transsphenoidal operations for histologically confirmed NFMAs (50 patients) and GH-secreting macroadenomas (25 patients) at the Brigham and Women's Hospital over an 18-month period. Patients with microadenomas and prior operations were excluded from the analysis. Preoperative MR images were reviewed to assess patterns of extrasellar extension in the varying tumor subtypes.Results. The mean maximal tumor diameter in NFMAs and GH-secreting macroadenomas was 26 and 16 mm, respectively (p < 0.0001). Extension of the NFMAs occurred into the following regions: infrasellar, 23 patients (46%); suprasellar, 41 patients (82%); and cavernous sinus, 20 patients (40%). Extension of GH-macroadenomas occurred into the following regions: infrasellar, 18 patients (72%); suprasellar, 4 patients (16%); and cavernous sinus, 4 patients (16%). Compared with GH-adenomas, NFMAs were more likely to develop suprasellar extension (82% vs 16%, p < 0.0001), cavernous sinus extension (40% vs 16%, p = 0.04), and isolated suprasellar extension (30% vs 4%, p = 0.0145). GH-macroadenomas had higher overall rates of infrasellar extension (72% vs 46%, p < 0.05), and isolated infrasellar extension (52% vs 6%, p < 0.0001). Of the 13 GH-macroadenomas with isolated infrasellar extension, 5 (42%) met WHO criteria for atypical adenomas.Conclusions. Substantial differences in extrasellar growth patterns were observed among varying histological subtypes of pituitary macroadenomas. Despite smaller tumor diameters, GH-macroadenomas demonstrated a proclivity for infrasellar extension, whereas NFMAs exhibited preferential extension into the suprasellar regio
机译：目的。已观察到垂体腺瘤的生长方式因组织病理学亚型而异。作者旨在分析非功能性大腺瘤（NFMA）和分泌生长激素（GH）的大腺瘤的鞍外扩展模式的变化。回顾性回顾了在Brigham and Women's Hospital进行了18个月的75例经蝶窦手术的患者的数据，这些患者经组织学证实为NFMA（50例）和GH分泌的大腺瘤（25例）。具有微腺瘤和先前手术的患者被排除在分析之外。回顾了术前MR图像，以评估不同肿瘤亚型的鞍外扩展模式。 NFMA和GH分泌型大腺瘤的平均最大肿瘤直径分别为26和16 mm（p <0.0001）。 NFMA的扩展发生在以下区域：腓骨下23例（46％）;鞍上41例（82％）;和海绵窦20例（40％）。 GH-Macroadenomas的扩展发生在以下区域：肌下，18例（72％）;鞍上4例（16％）;和海绵窦4例（16％）。与GH腺瘤相比，NFMA更有可能发生鞍上扩展（82％vs 16％，p <0.0001），海绵窦扩展（40％vs 16％，p = 0.04）和孤立的鞍上扩展（30％vs 4）。 ％，p = 0.0145）。 GH-Macroadenomas具有较高的整体骨下扩张率（72％比46％，p <0.05）和孤立的单一骨下扩张（52％vs 6％，p <0.0001）。在13例孤立性骨下延伸的GH肉瘤中，有5例（42％）达到了WHO的非典型腺瘤标准。在垂体大腺瘤的不同组织学亚型之间观察到了鞍外生长模式的显着差异。尽管肿瘤直径较小，但GH-Macroadenomas表现出了基底下延伸的倾向，而NFMAs表现出优先延伸到鞍上区域

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