Türk Nöroşirürji Dergisi 2016 , Vol 26 , Num 3
The Relationship Between the Hormonal Change and Age, Gender, Tumor Size, and the Type of Surgery in the Surgical Treatment of Pituitary Adenomas
Azer EKBEROV, Cahit KURAL, İlker SOLMAZ, Çağlar TEMİZ, Özkan TEHLİ, Engin GÖNÜL, Murat KUTLAY, Mehmet DANEYEMEZ, Yusuf İZCİ
Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Ankara, Türkiye AIM: Pituitary adenomas are one of the important intracranial tumors. They become symptomatic either by compressing important neurovascular structures or by deteriorating the hormon release. Today, surgical treatment provides promising clinical outcomes. But, it is not investigated how the surgical treatment changes the hormon release and what are the prognostic factors for these changes.

MATERIAL and METHODS: In this retrospective clinical study, the clinical, radiological data and hormonal profiles of 85 patients who underwent surgical treatment for pituitary adenoma between 2008-2012 are reviewed. The preoperative pituitary gland hormon values (Prolactin, GH, ACTH, TSH, FSH and LH) were compated with those of early (first 3 days) and late (1-3 months) postoperative periods. In these patients, the early and late postoperative hormon results were compared according to age and gender of the patients, preoperative tumor size and type of surgical approach.

RESULTS: Sixty-one (71.8%) of 85 patients were male and 24 patients (28.2%) were female with a mean age of 39.89 years. Thirty-three cases (38.82%) were non-secretory adenoma, 21 cases (24.70%) were GH-secreting adenoma, 16 cases (18.82%) were prolactin-secreting adenoma, 7 cases (8.23%) were mix adenoma (More than one hormon secreting adenoma), 6 cases (7.06%) were ACTH-secreting adenoma, 1 case (1.17%) was TSH-secreting adenoma and 1 case (1.17%) was FSH/LH secreting adenoma. Seventy-three patients (85.88%) were operated using endoscopic transsphenoidal route, 12 patients (14.12%) were operated by transcranial pterional approach. Based on the comparison of preoperative, early and postoperative hormon levels; there was statistically significant changes in prolactin, TSH, FSH and LH values (p<0.05), and no significant changes in ACTH and GH values. Moreover, there was no significant change in ACTH, GH, prolactin and TSH values based on the gender of patients. There was only a significant increase in late postoperative period in FSH and LH levels among the female patients. Based on the comparison of homonal changes according to the patients ages, hormonal outcome became more significant only in GH levels by the age (p<0.05). There was no relationship between the hormonal changes in other hormones and patients age. There was also no relationship between the hormonal changes and the type of surgery (p>0.05 for all hormones). There was also no correlation between the hormonal changes and the preoperative tumor size (p>0.05 for all hormones).

CONCLUSION: Surgical treatment is very effective on the decrease of prolactin, TSH, FSH and LH levels in patients with pituitary adenomas. GH levels significantly decrease by age after surgical treatment. In addition, FSH and LH levels increase in late postoperative period in female patients. The hormonal outcomes of the patients are not related to the gender of patients, preoperative tumor size and type of surgery. Anahtar Kelimeler : Pituitary adenoma, Surgical treatment, Hormon, Age