PITUITARY ADENOMA: CLINICAL EVALUATION AND SURGICAL MANAGEMENT

Abstract

ituitary adenoma is a benign tumor that develops in the pituitary gland, a crucial structure in the endocrine system. These adenomas can cause a variety of symptoms, affecting hormone production and, in some cases, compressing surrounding structures such as the optic nerve. Clinical assessment and surgical management are fundamental approaches in the management of patients with pituitary adenomas. Accurate decision-making is vital, considering the diversity of clinical presentations and the need for personalized treatment. Objective: to synthesize and analyze research published in the last 10 years on clinical assessment and surgical management in patients with pituitary adenomas. We seek to understand the diagnostic approaches, the most effective surgical strategies and the results of these interventions to improve the understanding and treatment of this condition. Methodology: To carry out this systematic review, the PubMed, Scielo and Web of Science databases were consulted, searching of studies published in the last 10 years. The five descriptors used included: "pituitary adenoma," "clinical evaluation," "surgical management," "surgical treatment," and "pituitary." The inclusion criteria for selecting the studies were: Studies published between 2013 and 2023; Studies related to the clinical evaluation and surgical management of pituitary adenomas; Studies in English, Spanish or Portuguese. The exclusion criteria covered: Studies published before 2013; Studies unrelated to the topic and studies in languages other than those mentioned. Results: The results of this systematic review highlighted a number of crucial topics related to clinical assessment and surgical management in patients with pituitary adenomas. The reviewed literature covered diagnostic methods including MRI and hormonal testing to determine tumor type and functionality. In addition, several surgical techniques were discussed, such as endoscopic transsphenoidal resection, which has been shown to be effective in removing pituitary tumors. The literature also highlighted the importance of a multidisciplinary approach, involving endocrinologists, neurosurgeons and ophthalmologists, to ensure the best patient care. Conclusion: In summary, this systematic review highlights the complexity of clinical assessment and surgical management in cases of pituitary adenomas. Accurate diagnosis and treatment of these tumors are essential to optimize clinical outcomes and improve patients' quality of life. The reviewed literature emphasizes the need for a personalized approach, taking into account the individual characteristics of tumors and collaboration between specialists from different areas. Recent research offers a comprehensive overview of management strategies and innovations in the treatment of pituitary adenomas, providing important guidelines for current and future clinical practice.