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Pituitary adenomas: is Gamma Knife® radiosurgery safe?

Nature Clinical Practice Endocrinology & Metabolism volume 1, pages 2–3 (2005)Cite this article

Gamma Knife® (Elekta Corporation, Stockholm, Sweden) radiosurgery has been used to treat more than 20,000 patients with pituitary adenoma. While great emphasis has been placed on avoiding injury to surrounding structures and preserving or improving neurologic function, Gamma Knife® radiosurgery has associated risks. In this Viewpoint, we discuss whether the complication rate falls below what should be considered a safe treatment option for pituitary adenomas.

Pituitary adenomas represent 10–20% of all primary brain tumors.1,2 Lesions are broadly classified into two groups, dependent on the presence or absence of secreted pituitary hormones. Tumors that secrete an excessive amount of hormone are associated with various clinical syndromes. The most common subtype is the prolactinoma, which results in amenorrhea–galactorrhea syndrome and infertility in women, and impotence and infertility in men. Growth-hormone-secreting pituitary adenomas cause acromegaly in adults and gigantism in children, and tumors secreting adrenocorticotropic-hormone cause Cushing's disease. Nonsecretory tumors, which secrete no known biologically active pituitary hormones, account for approximately 30% of all pituitary adenomas. They may, however, secrete luteinizing hormone, follicle stimulating hormone or α subunit.3 Adenomas in this group progressively enlarge in the pituitary fossa and often extend beyond the sella turcica. Such enlargement can cause optic-nerve and chiasm compression, and bitemporal visual field loss. Patients with a nonsecretory adenoma might also have hypopituitarism resulting from compression of the normal pituitary gland.

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Authors and Affiliations

  1. Assistant Professor of Neurological Surgery, the University of Virginia Health Sciences Center, VA, USA

    Jason Sheehan

  2. Professor of Neurological Surgery, the University of Virginia Health Sciences Center, VA, USA

    Ladislau Steiner

  3. Professor of Neurological Surgery, the University of Virginia Health Sciences Center, VA, USA

    Edward R Laws

Authors
  1. Jason Sheehan
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  2. Ladislau Steiner
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  3. Edward R Laws
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Correspondence to Jason Sheehan.

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The authors declare no competing financial interests.

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Sheehan, J., Steiner, L. & Laws, E. Pituitary adenomas: is Gamma Knife® radiosurgery safe?. Nat Rev Endocrinol 1, 2–3 (2005). https://doi.org/10.1038/ncpendmet0015

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