Giant pituitary adenomas

Abstract

A giant pituitary adenoma remains a major challenge for neurosurgeons, despite advances in en-doscopic endonasal surgery. These tumors can grow in different directions, which can affect the surrounding neurovascular structures. When the tumor grows towards the suprasellar region, it can affect important structures such as the optic nerves, anterior cerebral arteries, and hypothalamus. When it occupies the interpeduncular and prepontine cisterns, the oculomotor nerves or posterior communicating arteries may be at risk. Postoperative hemorrhage due to incomplete resection is also a concern and can lead to the need for revisional surgery or another surgical approach. Patients with giant pituitary adenomas typically have longer hospital stays due to the high rates of postoperative complications, such as cerebrospinal fluid leakage, diabetes insipidus, and infection. Gross total re-section rates are also lower for these types of tumors. This study provides a comprehensive review of the literature to date and reports various clinical outcomes associated with giant pituitary adenomas.