In our series to evaluate ACTH-producing pituitary adenomas,

we utilized the 24 h urine cortisol collection not excess of 200 μg/dL (550 nmol/dL) and the plasma cortisol level less than 2.5 μg/dL (69 nmol/dL) as the criteria for endocrinological evaluation. For patients treated with prolactinomas, we used normal serum prolactin level for gender as cure criteria and the normal PRL range for nonpregnant Sunitinib mouse women is <500 mU/L (20 μg/L) and for men <300 mU/L (12 μg/L). Meanwhile, we used the guidelines for a remission or cure as the GH level less than 1 ng/ml(2.5 mU/L) after glucose ingestion and a normal serum type-1 insulin like growth factor(IGF-1) when matched for age and gender to define the results of radiosurgery for patients with acromegaly. After irradiation of pituitary tissue, regular surveillance is needed to detect development of hypopituitarism, particularly GH deficiency. Basal pituitary profiles, including measurement of TSH, ACTH, gonadotropins, growth hormone,

IGF-1 and assessment for the clinical features of GH deficiency or consequent gonadal failure, were performed regularly on follow-up. The statistical analysis Statistical analysis was performed with the aid of commercially available software (StatView 4.5.1; Abacus Concepts, Inc., Berkeley, CA). Results MASEP GKRS was tolerated well in these patients. Acute radioreaction was selleck chemicals rare and 17 patients had transient headaches with no clinical significance. Consistent headache was noted in 1 patient 4 years Interleukin-3 receptor after radiosurgery and persisted for the entire 1 year during follow-up. There was no significant compression and the reason of headache was still unknown. Of the 68 patients with ACTH adenomas, 61(89.7%) showed tumor volume decrease or remain unchanged and 19(27.9%) experienced normalization of hormone level (Figure 1 and Figure 2). Of the other 5 patients with enlarged ACTH adenomas, 4 had repeated MASEP GKRS. One had craniotomy and resection of the mass after experiencing consistent vomiting.

Another two cases with no clinical symptom with a neuroradiological diagnosis of radiation necrosis received no more treatment. Of the 176 patients with prolactinomas, 41(23.3%) had normalization of hormone level and 159(90.3%) showed tumor volume decrease or remain unchanged (Figure 3 and Figure 4). Of the 12 patients with enlarged prolactinomas, 9 had repeated GKRS. Two had transsphenoidal resection of the mass after experiencing consistent headache. One case died 4 years after primary MASEP GKRS rejecting any medical intervention. Another 5 cases with the diagnosis of radiation necrosis had no clinical symptoms and lived as usual. Of the 103 patients with GH adenomas, 98(95.1%) experienced tumor volume decrease or remain unchanged and 38(36.9%) showed normalization of hormone level (Figure 5 and Figure 6). Of the other 3 patients with enlarged GH adenomas, 2 had repeated MASEP GKRS.