- Do you believe that it is a result of long-term DA treatment or its a primary variant of pituitary tumour?
- Do you observe the correlation between the invasiveness and firmation of PA?
You are right most adenomas preoperatively treated with DA show some sort of fibrosis which is related to the drug used.
some NFA are fibrous in nature, while in other cases, long-term DA are implicated.
functioning adenomas in general are usually softer in consistency.
Invasiveness is related only partly to fibrous content, rather more related to histopathology.
as such, ACTH staining adenomas (be it functioning or silent adenomas) are much more locally invasive and aggressive....
Fibrous adenomas are often described as "invasive" by the surgeon simply because they are difficult to remove from the cavernous sinus, carotid wall or optic nerve. As such many postoperative scans of fibrous adenomas show residual tumor in these areas, whereas most secretory adenomas are friable and allow complete resection.
Histopathology is a more objective measure of invasiveness. DA treatment does indeed predict some fibrosis.
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