Gamma Knife Radiosurgery: A New Therapeutic Tool of Relevance to the Endocrinologist

The management of pituitary adenomas entails a multidisciplinary approach that involves neurosurgeons, endocrinologists, and radiation oncologists. Traditionally, the treatment included medical management, surgery (transsphenoidal microsurgical resection and transcranial approaches), and conventional fractionated radiotherapy. Stereotactic radiosurgery, through the various competing radiosurgical techniques, has been shown to be effective in the management of residual or recurrent pituitary adenomas. It is effective in controlling adenoma growth and achieving endocrine remission. Brain metastasis from thyroid malignancies is rare, and gamma knife radiosurgery, like surgical resection, has been shown to be potentially beneficial. We have reviewed the outcome of gamma knife radiosurgery in the treatment of recurrent and residual pituitary adenomas and brain metastasis from thyroid carcinoma. The conclusion was that gamma knife radiosurgery is a safe and effective treatment for recurrent or residual pituitary adenomas, although surgery remains the primary treatment modality, and brain metastases from thyroid carcinoma.