Incidence and clinical outcomes of atypical pituitary adenomas

Abstract Background Atypical pituitary adenoma has a high rate of recurrence and most of them need further treatment after surgery. This is why early detection is very important. Methods In this study we examined the incidence and outcome of large atypical pituitary adenoma in our patient cohort. The study was a retrospective review of fifty consecutive patients at Assiut university hospital. They all had a large adenoma with supracellar and parasellar extension. They were considered unsuitable for transphenoidal approach. They all had craniotomy. This study was carried out during a thirty eight month period. Pathology reports were reviewed. All patients had MIB-1 immunohistochemical data. Patients with lesions showing excessive MIB-1immunoreactivity and mitotic features had p53 immunohistochemical data. Results Ten (20%) of our patients had lesions that met all the criteria for atypical adenoma. Conclusion Atypical pituitary adenoma tend to be aggressive and invasive macroadenomas. Following surgery, further treatment such as radiotherapy should be considered