Surgical management of giant pituitary tumours--a review of 30 cases.

An experience with surgical management of 30 giant pituitary tumours is analysed in this report. The clinical features, anatomical spread and relationship of these tumours with the cavernous sinus and other parasellar and basal forebrain structures is analysed. The problem encountered in the surgical treatment are reviewed. An unusual feature in the management was an intra-operative and post-operative tumour swelling and acute elevation of the intracranial pressure in 5 patients. Despite the technical problems encountered during surgery and in the post-operative period it was observed that a significant resection and adequate decompression of the visual apparatus offered a reasonable opportunity for recovery in vision and a satisfactory outcome. Complete resection of the tumour was not possible in this series. A contralateral subfrontal route was seen to be most suitable for resection of the part of the tumour that invaded the cavernous sinus.