Introduction: When facing with non-functioning pituitary macroadenomas (NFPMA), radiological invasion is determinant to surgical approach, apart from histological biomarkers of pituitary tumor aggressiveness (Ki-67; p53 and mitotic index). Invasive tumors usually need additional surgery and/or radiotherapy. There are no much studies describing epidemiological data on aggressive pituitary tumors in clinical practice. We provide information regarding the radiological findings of NFPMA in a single tertiary center during 17 years.
Material and methods: We evaluate retrospectively MR imaging of NFPMA diagnosed between 1999 and 2016 in our Hospital. Evaluation includes infrasellar invasion, Knosps classification in both cavernous sinus, measure in three dimensions, contact with quiasm, and intensity of signal in T2.
Results: From 48 cases, we selected 41 with valuable presurgical MRI. 15 men and 26 women, mean age 61 years (2483). Infrasellar invasion ocurred in 19 (46.34%), Knosp III or IV in 21 of 82 cavernous sinus (25.6%). 3 patients (7.3%) presented invasion of three areas. Mean craneocaudal diameter was 29.65 mm (852), transversal 21.5 mm (1143) and anteroposterior 19.14 mm (1151), with 80.5% displacing optic quiasm. 22% were giant adenomas (>40 mm) and T2 secuences hiperintense, suggesting scarcely granulated tumour, was present in 19.5%.
Conclusions: In our series, 56% of NFPMA had criteria of radiological invasión, infrasellar or cavernous sinus invasion. This finding remarks the complex management of these neoplasm and the need of a multimodal approach.
20 May 2017 - 23 May 2017