Guk M. Diagnosis and comprehensive treatment of hormonally-inactive pituitary adenomas

This dissertation is devoted to the improvement of diagnosis and comprehensive treatment of hormonally-inactive pituitary adenomas. For the first time prevalence of hormonally-inactive pituitary adenomas in the structure of pituitary tumors was shown on a large clinical material. Based on the analysis of the results of complex clinical-endocrinological, and improved neurovisualised and neuropathomorphological tests the understanding of the pathogenesis, invasiveness and recurrence hormonally inactive pituitary adenomas was deepened. Role of pseudocapsule in the pathogenesis of hormonally-inactive pituitary adenomas was proven and polymorphism of these tumors was shown based on in-depth immunohistochemical studies. Features of endocrine disorders in hormonally-inactive pituitary adenomas were studied and systematized, so in that way the principles of reasonably early diagnosis and multidisciplinary approach were described. The use of surgical treatment of hormonally-inactive pituitary adenomas in asymptomatic and oligosymptomatic stages of the disease was proved. Invasive types of hormonally-inactive pituitary adenomas and peculiarities of surgical treatment of recurrences were systematized. The necessity of initial maximum radical extracapsular removal in possible cases was assessed for hormonally-inactive pituitary adenomas. For the first time in Ukraine a comparative analysis of endoscopic and microsurgical techniques of transnasal pituitary adenomas removal was done. New clinical-surgical approach to the allocation of hormonally-inactive pituitary adenomas types was developed and implemented regarding to the possibility of a successful radical surgical treatment. The mechanisms of empowerment for surgical treatment and improvement the efficiency of comprehensive treatment of hormonally inactive-pituitary adenomas were found.