ENDOCRINE DISTURBANCES IN PARASELLAR MENINGIOMAS AND THE EFFECT OF TRANSSPHENOIDAL DECOMPRESSION OPERATIONS

Acta Endocrinol (Buchar). 2025 Jan-Mar;21(1):67-73. doi: 10.4183/aeb.2025.67.

Abstract

Objective: To assess the outcome of clinical and endocrinological dysfunctions after transsphenoidal decompression in parasellar meningioma.

Methods: Retrospective pre- and postoperative evaluation of 40 patients (30 women, 10 men; mean age, 55.9±11.9) who underwent decompressive transsphenoidal microsurgeries. The preoperative investigation took place one month prior surgery, the first follow-up within one week, the second follow-up within three months postoperatively.

Results: The most common symptom in our study was diplopia (47.5%, n=19) which showed improvement in 21.1% (n=4) of cases. Preoperative hyperprolactinemia, presented in 52.5% of patients (n=21) with hyperprolactinemia remaining in just 20% of patients (n=8) in the first follow-up. Other endocrine axes were affected less frequently, but also majorly showed improvements. The corticotropic axis was affected in 8.8% (n=3) and remained unchanged. Female gonadotropic axis irritation decreased from 34.5% (n=10) to 31.0% (n=9), male axis deterioration improved in two cases from 50% (n=5) to 30% (n=3). The somatotropic and thyrotropic axes were never negatively affected. Adjuvant radiotherapy was carried out in 60% (n=24) of patients and not yet commenced in an additional nine (22.5%).

Conclusion: Experience shows that transsphenoidal decompression is a useful and low complication associated procedure in the initial management of cavernous sinus meningioma.

Keywords: Cavernous sinus; Hypopituitarism; Meningioma; Parasellar tumour; Pituitary tumour; Transsphenoidal surgery.