Minimally Invasive Endoscopic Endonasal Transphenoid Approach for Resection of Pituitary Macroadenoma: Case Report and Literature Review

Pituitary adenomas are common benign tumors that may or may not produce hormones that are rarely malignant. Those that do not generate hormones are considered non-functioning or non-secretory. Non-secretory pituitary adenomas are defined as tumors of the pituitary gland that lack the characteristic of hormone hypersecretion and account for 18 to31% of all surgically treated pituitary adenomas [1]. The size of the lesion, its proximity to the optic chiasm and tracts, amount of osseous infiltration as well as tendency to invade the parasellar space and lack or presence of hormone hyper secretion are factors that determine the treatment strategies of pituitary adenomas. Transsphenoidal endoscopic resection is the most widely used surgical procedure for the resection of non-secretory pituitary adenomas, due to the yield of satisfactory results and relatively low complication rate. Here we describe a case of recurrence of a non-functioning pituitary adenoma after Gamma Knife Radiotherapy treatment, followed by an endoscopic endonasal transsphenoidal approach for resection.