Minimally invasive approach to management of pituitary adenomas.

Pituitary adenomas are the third most common benign intracranial tumor seen in neurosurgical practice. They represent >or= 15 % of all primary intracranial tumors with 25 % prevalence as reported in autopsy series. Advances in biomedical assays, imaging studies support their diagnosis and tailor their management. The direct endonasal transsphenoidal surgery is the recommended intervention for adenoma resection in more than 95 %. The safety and efficacy of this intervention was enhanced by microsurgery and more recently by the introduction of neuronavigation, assisted endoscopy and intraoperative MRI. Anticipation of clinical, biochemical, radiological and surgical pitfalls by a multidisciplinary team is of paramount importance in improving treatment and preventing potential complications.