Guerrero-Pérez Fernando, Biagetti Betina, Paja-Fano Miguel, Menéndez-Torre Edelmiro Luis, Rivero Gonzalo, Dios Elena, Hanzu Felicia Alexandra, Martín Rojas-Marcos Patricia, Irigaray Ana, Moure Rodríguez María Dolores, García-Centeno Rogelio, González Fernández Laura, Enseñat Joaquim, Mora Mireia, Villar-Taibo Rocío, Ortiz García Isabel M, Araujo-Castro Marta, Gándara Carmen, Ollero García M Dolores, Tenorio-Jiménez Carmen, Novo-Rodríguez Cristina, Civantos Soralla, Simó-Servat Andreu, Aulinas Anna, Asla Queralt, Cordido Fernando, Novoa-Testa Iría, Xifra Gemma, Ayala-Conte María, Zamarrón Álvaro, García Berrocal M Isabel, Iglesias Pedro
Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, Barcelona, Spain.
Biomedical Research Institute of Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Pituitary. 2024 Dec 28;28(1):12. doi: 10.1007/s11102-024-01484-y.
Studies focused on the effects of sellar and/or perisellar (S/PS) meningiomas on pituitary function are scarce. The primary objective of the present study was to determinate the effects that S/PS meningiomas and their treatments have on pituitary function. Also, we described the clinical characteristics and therapeutic outcomes of the cohort of adult Spanish patients.
A multicenter and retrospective study of patients with S/PS meningiomas attended in 20 tertiary Spanish centers.
165 patients, 123 (74.5%) females, with median age of 61.4 [51-71] years were analyzed. At presentation, 115 (69.7%) had visual disturbance, 62 (37.6%) headache, 46 (27.9%) cranial nerve palsy and 34 (26.2%) hypopituitarism. Median tumor diameter was 29.1 [22-35.5] mm and cavernous sinus infiltration was detected in 95 (59%). As initial treatment, 128 (77.6%) underwent surgery, 25 (15.2%) received radiotherapy and 12 (7.3%) were clinically and radiologically monitored. Among operated patients, gross total resection (GTR) was achieved in 44 (34.4%), whereas in 84 (65.6%) the tumor was incompletely removed. Overall median follow-up was 5.7 [2.9-9.2] years. After treatments, hypopituitarism was present in 86 (53.4%) patients at the last evaluation, and it was associated with surgery extension (subtotal or GTR) but not with tumor subtype, type of radiotherapy or radiation dose received.
S/PS meningiomas affect the pituitary function in 25% of the cases. However, after the implementation of treatments, hypopituitarism prevails in more than 50% of the cases. They are relatively large tumors and GTR is achieved in one third of the cases in whom hypopituitarism is more prevalent.
关于鞍区和/或鞍周（S/PS）脑膜瘤对垂体功能影响的研究较少。本研究的主要目的是确定S/PS脑膜瘤及其治疗方法对垂体功能的影响。此外，我们描述了西班牙成年患者队列的临床特征和治疗结果。
对西班牙20个三级中心收治的S/PS脑膜瘤患者进行多中心回顾性研究。
分析了165例患者，其中123例（74.5%）为女性，中位年龄为61.4[51 - 71]岁。就诊时，115例（69.7%）有视力障碍，62例（37.6%）有头痛，46例（27.9%）有脑神经麻痹，34例（26.2%）有垂体功能减退。肿瘤中位直径为29.1[22 - 35.5]mm，95例（59%）检测到海绵窦浸润。作为初始治疗，128例（77.6%）接受了手术，25例（15.2%）接受了放疗，12例（7.3%）进行了临床和影像学监测。在接受手术的患者中，44例（34.4%）实现了全切除（GTR），而84例（65.6%）肿瘤未完全切除。总体中位随访时间为5.7[2.9 - 9.2]年。治疗后，在最后一次评估时，86例（53.4%）患者存在垂体功能减退，且其与手术范围（次全切除或GTR）相关，但与肿瘤亚型、放疗类型或接受的辐射剂量无关。
S/PS脑膜瘤在25%的病例中影响垂体功能。然而，在实施治疗后，超过50%的病例存在垂体功能减退。它们是相对较大的肿瘤，在垂体功能减退更为普遍的病例中，三分之一的病例实现了GTR。
