Clinical and Radiographic Characteristics and Postoperative Outcomes of a Single-Center Experience of Combined Endoscopic and Transcranial Approach for Giant Pituitary Neuroendocrine Tumors.

This article discusses the clinical and radiographic characteristics, as well as the postoperative outcomes, of a combined endoscopic and transcranial approach for giant pituitary neuroendocrine tumors (PitNETs). The study, conducted at the University of Washington between 2011 and 2022, included 13 patients who underwent the combined approach. The results showed that the combined approach allowed for enhanced visualization and improved working angles, increasing the likelihood of achieving gross total resection. However, residual tumor in the cavernous sinus or adherent to critical neurovascular structures often limited complete resection. Complications of the combined approach included CSF leak, vasospasm, meningitis, hemorrhage, and hydrocephalus. Some patients required readmission within 30 days, and recurrence/progression occurred in a portion of the patients. One patient died due to extensive vasospasm and stroke. Overall, the combined approach shows promise for the resection of giant pituitary adenomas, but further research is needed to optimize outcomes. [Extracted from the article]