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Pituitary Adenomas

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RATIONALE AND JUSTIFICATION OF STUDY
Pituitary adenomas are one of the most common intracranial tumors and constitute 10% to 20% of all primary brain tumors. They are generally classified as either “functioning” or “nonfunctioning,” with functioning (secretory) adenomas representing approximately 70% of all pituitary tumors1, 2.
Clinically, pituitary adenomas present with a classic semiologic triad related to hypersecretion, hypopituitarism, mass effect (headache, visual disturbances, and hydrocephalus) or as incidentalomas discovered during neuroimaging for the management of other disorders; occasionally pituitary apoplexy, or rarely as cerebrospinal fluid rhinorrhoea3.
A suspected case of pituitary adenoma will require a coordinated two step
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Current therapeutic options include medical, surgical and radiotherapeutic methods with the latter being rapidly replaced by radiosurgery. Pituitary tumors are well-suited for radiosurgery, since radiation can be focused on a well circumscribed region, while adjacent neural structures in the suprasellar and parasellar regions are spared 1, 2, 4-8.
Stereotactic radiosurgery uses sophisticated 3-D computerized imaging to precisely target an ionizing ray and deliver a high concentrated dose of radiation to the lesion. Stereotactic radiosurgery differs and is advantageous over conventional surgery because there is no incision involved and general anesthesia is not required for adults, and short treatment duration amongst others4, 5.
The expected dominance of the time-honoured microscopic pituitary surgery technique as the “gold standard” for pituitary surgery seems to be fading out while the endoscopic techniques are on a rise. Microsurgical resection alone provides a long-term tumor control rate of only 50% to 80% and a long-term remission rate of endocrinologic normalization after surgical resection that often falls short of expectations. Reoperation for residual or recurrent tumors is associated with the more difficult complete resection and the endoscopic method alone is insufficient to solve all problems associated with these cases6. Hence the need for a complementary
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