Current status of endoscopic endonasal pituitary surgery in kinshasa democratic republic of congo, case report and literature review

• Endoscopic endonasal pituitary surgery proved feasible and effective in a resource-limited center in Kinshasa. • This study provides rare neurosurgical evidence on pituitary adenoma management from Sub-Saharan Africa. • Visual recovery and endocrine stabilization were achieved despite significant diagnostic and infrastructural constraints. • The series underscores the clinical heterogeneity of pituitary adenomas, from apoplexy to refractory prolactinoma. • Expanding pituitary care in low-resource settings will require training, follow-up systems, and access to essential therapies. Pituitary adenomas are among the most frequent intracranial tumors, often producing significant endocrine and visual morbidity. Endoscopic endonasal surgery has become the preferred treatment worldwide, though data from Sub-Saharan Africa remain scarce. We report the experience from Kinshasa, Democratic Republic of Congo (DRC), combining a case series with a literature review to evaluate clinical presentation, management strategies, and outcomes in a resource-limited environment, emphasizing both feasibility and challenges of minimally invasive pituitary surgery. We conducted a retrospective review of patients with pituitary adenomas treated at Clinique Ngaliema, Kinshasa, between 2020 and 2025. Clinical, radiological, and endocrine data were extracted, with outcomes assessed after surgical or pharmacological treatment. A systematic review of studies published from 2020 to 2025 was also performed across PubMed, Scopus, and Web of Science. Key data on presentation, treatment modality, complications, recurrence, and follow-up were synthesized into comparative tables to contextualize findings within global experience. Three patients (two female, one male; aged 38–56 years) underwent evaluation and management. Clinical presentations included visual disturbance, apoplexy, and refractory hyperprolactinemia. Two patients underwent successful decompression, and one proceeded to surgery after medical therapy. Outcomes were favorable overall, with stable neurological function, though infertility persisted in one case. Endoscopic endonasal pituitary surgery is feasible and effective in the Democratic Republic of Congo, achieving symptom relief despite limited infrastructure. However, inadequate hormonal testing, scarce medical therapy, and absence of structured follow-up restrict long-term disease control. Strengthening local expertise, regional registries, and sustainable partnerships will be essential to reduce disparities and align outcomes with global standards.