Pituitary Adenomas with Subarachnoid Invasion: Surgical Nuances and Outcomes.

This article discusses the surgical management and outcomes of pituitary adenomas with subarachnoid invasion. The study analyzed data from 321 patients who underwent an endoscopic endonasal approach for pituitary adenoma resection, and identified 13 patients with subarachnoid invasion. The surgical approach for these tumors involved careful dissection from surrounding neurovascular structures to achieve safe resection. Patients with subarachnoid invasion were more likely to have subtotal tumor resection and require additional treatment, such as medical therapy, radiation, or repeat resection. They also experienced higher rates of intra-operative CSF leak, postoperative diabetes insipidus, post-operative hematomas, and the need for adjuvant interventions. Overall, pituitary adenomas with subarachnoid invasion present unique challenges and require specialized surgical techniques. [Extracted from the article]