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KMID : 0942820060050020115
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Journal of Korean Brain Tumor Society
2006 Volume.5 No. 2 p.115 ~ p.119
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Extracapsular Approach for Pituitary Macroadenoma - Report of 2 Cases -
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Park Yeul-Bum
Kim Min-Su
Kim Seong-Ho
Kim Oh-Lyong
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Abstract
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Pituitary adenoma is one of the most common benign intracranial neoplasms. As the tumor enlarges, it compresses the surrounding pituitary gland, ultimately producing a pseudocapsule. We reviewed the clinical advantage and side effect of the extracapsular approach. A 66-year-old female was brought to the hospital due to bitemporal hemianopsia and headache. A brain magnetic resonance image showed a 16×32mm macroadenoma. The second case was a 57-year-old male who was brought to the hospital due to progressive visual loss. Radiologic evaluation showed a 20×32mm macroadenoma. By trans-sphenoidal microsurgery, we approached the outer part of the pseudocapsule between the normal pituitary gland along the tumor and surgically removed the adenoma. Histology showed tumor cell invasion in pseudocapsule. A follow up brain MRI showed total removal of the pituitary macroadenoma. A complication was cerebrospinal fluid leakage. The extracapsular approach for pituitary macroadenoma may be useful for one stage removal as it does not require additional maneuvers to push the tumor downward. However, careful dissection is necessary to avoid cerebrospinal fluid leakage.
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KEYWORD
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Pituitary macroadenoma, Pseudocapsule, Extracapsular approach
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