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01.09.2021 | Review Article

Clinical relevance of tumor consistency in pituitary adenoma

verfasst von: Alberto Acitores Cancela, Víctor Rodríguez Berrocal, Héctor Pian, Juan Salvador Martínez San Millán, Juan José Díez, Pedro Iglesias

Erschienen in: Hormones | Ausgabe 3/2021

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Abstract

Purpose

To review the clinical relevance of pituitary adenoma (PA) consistency and its relationship to clinical presentation, radiologic and histopathological characteristics, and surgical outcomes.

Background

PA consistency is a critical factor influencing operative planning, surgical outcomes, and patient counseling. There is no validated classification of PA consistency in the literature, and there are no current preoperative variables capable of predicting it.

Review

We conducted a thorough literature review of the Medline, Embase, Web of Science, and Cochrane Library databases. The inclusion criteria were all articles that described PA consistency and correlated it with preoperative aspects, radiological, pathological, and operative findings, or clinical outcomes.

Discussion

Although most authors differentiate easily aspirated (soft) tumors from those that are not (fibrous, might require prior fragmentation), there is no universally accepted PA consistency classification. Fibrous PA tends to be hypointense on T2WI and has lower apparent diffusion coefficient (ADC) values. Fibrous tumors seemed to present higher invasion into neighboring structures, including the cavernous sinus. Several articles suggest that dopamine agonists could increase PA consistency and that prior surgery and radiotherapy also make PA more fibrous. The anatomopathological studies identify collagen as being mainly responsible for fibrous consistency of adenomas.

Conclusions

Preoperative knowledge of PA consistency affords the neurosurgeon substantial benefit, which clearly appears to be relevant to surgical planning, risks, and surgery outcomes. It could also encourage the centralization of these high complexity tumors in reference centers. Further studies may be enhanced by applying standard consistency classification of the PA and analyzing a more extensive and prospective series of fibrous PA.

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Titel: Clinical relevance of tumor consistency in pituitary adenoma
verfasst von: Alberto Acitores Cancela
Víctor Rodríguez Berrocal
Héctor Pian
Juan Salvador Martínez San Millán
Juan José Díez
Pedro Iglesias
Publikationsdatum: 01.09.2021
Verlag: Springer International Publishing
Erschienen in: Hormones / Ausgabe 3/2021
Print ISSN: 1109-3099
Elektronische ISSN: 2520-8721
DOI: https://doi.org/10.1007/s42000-021-00302-5

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Clinical relevance of tumor consistency in pituitary adenoma

Abstract

Purpose

Background

Review

Discussion

Conclusions

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