Endocrinological outcome after pituitary transposition (hypophysopexy) and adjuvant radiotherapy for XXXX involving the cavernous sinus.

@entity1 @entity511 @entity41 @entity2695 @entity5 @entity2698 @entity1161 @entity260 @entity4614 @entity1653 @entity3580 @entity977 @entity86
OBJECT: Stereotactic radiosurgery and fractionated stereotactic radiotherapy are commonly used in the treatment of residual or recurrent @entity5 and cavernous sinus. A major risk associated with radiosurgical or radiotherapy treatment of residual or recurrent @entity5 adjacent to normal functional pituitary gland is radiation of the pituitary, which frequently leads to the development of @entity4614 . The authors have used a technique of pituitary transposition to reduce the radiation dose to the normal pituitary gland in cases of planned radiosurgical treatment of @entity41 within the cavernous sinus. Here, the authors analyze the long-term endocrinological outcomes in @entity1 with residual and recurrent @entity5 who undergo hypophysopexy and adjuvant radiosurgical or conformal fractionated radiotherapy treatment. METHODS: Pituitary transposition involves placement of a fat graft between the normal @entity977 in the cavernous sinus. A sellar exploration for @entity5 resection is performed, the pituitary gland is transposed from the region of the cavernous sinus, and the graft is interposed between the @entity977 . The @entity41 may then be treated with stereotactic radiosurgery or conformal fractionated radiation therapy. The authors evaluated endocrinological outcome, safety of the procedure, and @entity260 in @entity1 who underwent this procedure during a 7-year period. RESULTS: Hypophysopexy has been used in 34 @entity1 with nonfunctioning @entity977 (19), functional @entity977 (8), @entity3580 (2), @entity1653 (2), @entity511 (1), @entity2698 (1), or @entity2695 (1) involving the sella and cavernous sinus. Follow-up (radiographic and endocrinological) has been performed yearly in all @entity1 . Two @entity1 experienced @entity86 before radiosurgery (1 transient), but none of the @entity1 developed new @entity4614 during the median 4-year follow-up (range 1-8 years) after radiosurgery or fractionated stereotactic radiotherapy. CONCLUSIONS: The increased distance between the normal @entity977 facilitates treatment of the @entity5 with radiosurgery or radiotherapy and effectively reduces the incidence of @entity1161 to the normal pituitary gland when compared with historical controls.
