Transsphenoidal surgery for @entity4090 -secreting XXXX : a study of 28 cases and review of the literature.

@entity1 @entity6726 @entity5 @entity4090 @entity977 @entity2588
Twenty-eight @entity1 (22 @entity1 , six @entity1 ) underwent transsphenoidal microsurgery for suspected @entity4090 -secreting @entity977 . @entity2588 was present in 19 of the 22 @entity1 , and @entity6726 , in 21 of the 22 @entity1 and two of the six @entity1 . @entity4090 values preoperatively ranged from 62 to 38,130 ng/ml, and the mean percentage decrease in serum @entity4090 ( @entity4090 ) after surgery was 80% (range: 38% to 99%). Twenty @entity1 had microadenomas ( @entity5 less than 10 mm), and seven had macroadenomas (greater than 10 mm). Although no @entity5 was found in one patient, her serum @entity4090 fell from 65 to 24 ng/ml postoperatively. Surgical results depended upon both the initial @entity4090 level and the @entity5 size. All eight @entity1 with @entity5 of less than 10 mm and @entity4090 levels of less than 200 ng/ml had normal postoperative @entity4090 values, whereas serum @entity4090 returned to normal in only four of eleven @entity1 with microadenomas but with preoperative @entity4090 of greater than 200 ng/ml. None of the five @entity1 with macroadenomas in who serum @entity4090 had been measured preoperatively had normalization of serum @entity4090 postoperatively, including one @entity1 with a preoperative level of less than 200 ng/ml. Menses resumed in 11 of 18 @entity1 ; @entity6726 improved in six of 11 subjects, and nine pregnancies have occurred. Analysis of these data, as well as those of 12 published series, suggests that both @entity5 size and the preoperative serum @entity4090 level are important factors in predicting the success of surgical therapy. Longitudinal follow-up is imperative to determine which @entity1 are truly cured.
