임상 : 성장 호르몬 분비 뇌하수체 선종 환자의 수술적 치료 결과 = Surgical Outcomes of Patients with Growth Hormone Secreting Pituitary Adenoma

다국어 초록 (Multilingual Abstract)

Objective：Control of growth hormone(GH) and insulin-like growth factor-I(IGF-I) levels are important in patients with GH-secreting adenomas because they are indicators of biochemical control of GH-secreting adenomas characterized by serious cardiovascular and metabolic complications. Surgical treatment is usually considered as the first choice of treatment in GH-secreting adenomas. In this study, we evaluated the efficacy and safety of surgical treatment with GHsecreting pituitary adenoma. Methods：We have reviewed medical records, radiologic findings, and endocrinologic evaluations of patients with GHsecreting pituitary adenoma who were treated by surgery between 1996 to 2004. Results：Twenty eight cases of GH-secreting pituitary adenoma(15 males and 13 females) have underwent surgery in our institute. The twenty eight cases included 22 patients with macroadenoma and 6 patients with microadenoma. Preoperative GH levels ranged between 1.77 and 82 μ/L(mean 20.7±14.3 ng/ml) and preoperative IGF-I levels ranged from 424 to 1710 ng/ml(mean 905.3±374.96 ng/ml). And the maximum diameter of tumors were between 4 mm and 70 mm. Twenty six patients were operated by transsphenoidal surgery and 2 patients underwent transcranial surgery. Gross total resection was achieved in 25 of the 28 cases. All patients` serum GH levels after oral glucose tolerance test(oGTT) decreased after surgery. Surgical cure after surgery(mean GH <2 μ/L and a nadir value after oGTT of <1 μ/L) was founded in 13 patients(8 of 22 macroadenoma and 5 of 6 microadenoma). No cases of mortality or major immediate postoperative complications were observed. Conclusion：Surgical treatment is safe and effective and we suggest the surgery could be a primary treatment not only for GH-secreting microadenoma but also for macroadenoma with cavernous sinus invasion.