Effects of Transshenoidal Surgery on Patients with Nonfunctioning Pituitary Tumours

Objective:   The present study was undertaken to assess the effect of surgical removal of adenoma on peripheral adenohypophyseal hormones. In addition, the pituitary hormones have also been measured directly in the adenoma tissue following its surgical removal. Materials and Methods:  The present study initially included 22 consecutive patients 18 men and 4 women, of 22-55 (44 ± 2.3) years of age operated for NFMA between 2005 and 2008 at Lahore General Hospital, Lahore. Three of these patients 2 men and 1woman died during the follow-up period and were excluded from the study.  Results:  Radiological imaging revealed a macroadenoma in all patients, with suprasellar extension in 96% and parasellar/infrasellar extension in 32% of cases. Visual field defects were present in 95% of the patients and improved in 84% of cases after surgery (complete recovery 3/19 (15%); partial recovery 13/19 (68%). The results demonstrate that in a subset of 4 of the 16 male patients with NFPAs the presurgical serum FSH values (45.1 ± 0.7 mIU/ml) were markedly and significantly greater than those of the remaining 12 patients (7.9 ± 0.7 mIU/ml) and of control subjects (8.8 ± 0.6 mIU/ml).  Conclusions:  The present study suggests that pituitary tumours diagnosed as NFPAs constitute a heterogenous group of adenomas with regard to their secretory activity of intact adenohypophyseal hormones. Whereas some of these adenomas activity may synthesize one or more pituitary hormones, peripheral concentrations may not be sufficient to produce overt clinical symptoms of hormone hypersecretion.&nbsp