Endocrine Abstracts

JOINT2705

Introduction: Crooke’s cell adenoma (CCA) is a rare subtype of pituitary adenoma (<1%). CCAs are usually invasive, may exhibit aggressive behavior, and often recur. Thus, the treatment of CCAs is difficult and might not result in a complete remission. The aim of this study was to assess characteristics of a group of patients with CCAs treated with endoscopic endonasal resections.

Material and Methods: The study is a retrospective analysis of a series of 18 patients (6 women and 12 men) treated from the 2015 to 2024 by the endoscopic transsphenoidal surgeries for CCAs. The mean age of the patients was 48.3 years (18-77 years), and the mean follow-up period was 5.3 years (0-11 years).

Results: Preoperatively 8 patients had visual function deterioration (44.4%), 8 patients had Cushing’s disease (44.4%), 6 patients had hypopituitarism (33.3%), 4 patients had headaches (22.2%). Gross total resections were achieved in 6 out of 8 patients with Cushing’s disease (75%), and in 7 out of 10 patients with silent adenomas (70%). Most patients (88.9%) had macroadenomas. Five patients (27.8%) had an intra-operative cerebrospinal fluid leak, and a reconstruction of the sella with a fat tissue graft. Postoperatively 75% of the patients showed varying improvement in visual field defects and visual acuity. The only complication was transient diabetes insipidus (DI) observed in 3 patients (16.7%). One patient progressed to pituitary carcinoma, had four subsequent resections, and eventually died. The remission of Cushing’s disease was achieved in 6 patients after surgery (75%).

Conclusions: Endoscopic transsphenoidal treatment of patients with CCAs is safe and associated with a low complication rate. The patients are younger and have more resections than in usual pituitary adenomas.