Visual and endocrine outcome following surgery for pituitary adenoma in a tertiary hospital, North Central Nigeria

Br J Neurosurg. 2022 Apr 28:1-4. doi: 10.1080/02688697.2021.1947973. Online ahead of print.

Abstract

Background: It becomes expedient in our emerging practice to evaluate the outcome of pituitary surgery.

Aims and objectives: Outcome following Surgery for Pituitary Adenoma in a Resource Challenged Tertiary Hospital.

Methods: Retrospective review of cases of surgery for pituitary adenomas (Jan 2013-Dec 2017).

Results: Total 28 out of 57 cases (49%) had surgery. M: F 3:1. Mean age of 44 years (range 21-72 years). 23/28(82%) were referred from eye clinics. Commonest presentation was visual impairment (100%) and Hormone dysfunction. Mean time to presentation was 29 months. Commonest pre-op diagnosis was non-functional adenoma 24/29 (85.7%). Commonest surgical approach was transsphenoidal surgery 20/28 (70.1%). At 12 months, visual improvement was recorded in 39.2%. Some improvement in hormone status was recorded but prolactinemia persisted in 7.1% while GH secreting persisted in 3.5%. Residual/recurrent tumor at 12 months scan was recorded in 59.2%.

Conclusion: A marginal improvement in vision was observed but hypocortisolism and low thyroid hormones were restored to normalcy at 12 months. However, Growth Hormones and Prolactin remained mostly unchanged at 12 months.

Keywords: pituitary adenomas; pituitary surgery; endocrine and visual outcome; resource challenged environment.