Characteristics and outcome of surgically treated pituitary tumours in South Africa: a single-centre experience

Abstract

Aims

To describe the clinical, biochemical, radiological and histological features and to determine the outcome of all patients with pituitary tumours treated surgically at Inkosi Albert Luthuli Central Hospital in Durban over a 5 year period.

Research design

Retrospective chart review from 2008 to 2012. Clinical, biochemical and radiologic data were collected before and one year after surgery. Histopathology findings and peri-operative complications were recorded.

Results

Seventy patients were included (age 44.8 ± 14.9 years, 55.7% female). Headache (84.1%) and visual disturbances (78.3%) were the predominant presenting symptoms (84.1% and 78.3%). Most tumours were macroadenomas (97.1%). Trans-sphenoidal surgery was employed in the majority (90%). A single procedure was required in 55.7% patients, two procedures in 30% and up to six in others. Complete resection was achieved in only 9 patients (12.8%), residual tumour post-surgery was found in 48 (68.6%) and no change in tumour size was found in 13 (18.6%) patients. Additional medical therapy was used in 22 (31.4%) and radiotherapy in 13 (18.6%). On biopsy, the most common pathology was non-functional adenoma in 33 (47.1%); 29 (41.4%) were secretory tumours and 8 (11.4%) were craniopharyngiomas. Overall mortality was 4.3%. The commonest surgical complication was cerebrospinal fluid (CSF) leak (10%; n=7). New post-surgical pituitary hypofunction occurred in 50 (71.4%) patients. The outcome at one year was similar to that on discharge.

Conclusions

Patients presenting to IALCH had large tumours, and complete resection was achieved in a minority. There was a low overall mortality but high rate of post-surgical pituitary hypofunction.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fMD45j