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Vol. 17. Issue 6.
Pages 538-541 (January 2006)
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Vol. 17. Issue 6.
Pages 538-541 (January 2006)
Macroadenoma de hipófisis descubierto incidentalmente. Indicaciones del tratamiento quirúrgico a propósito de dos casos
Incidentally discovered pituitary macroadenoma. Neurosurgical treatment indications illutrated by two cases
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C. Maciá-Bobes
, G. Castaño-Fernández, P. Botas-Cervero
Unidad de Endocrinología. Hospital San Agustín. Avilés. Asturias
A. Ronzón-Fernández*
* Unidad de Medicina de Familia. Hospital San Agustín. Avilés. Asturias
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Resumen

Los macroadenomas hipofisarios (de diámetro superior a 10mm) son poco frecuentes como hallazgos casuales, y su manejo diagnóstico y terapéutico no está bien definido. Los criterios más habituales para el tratamiento neuroquirúrgico son la afectación del campo visual, la hipersecreción de hormonas distintas a la prolactina, la constatación de crecimiento, o la apoplejía no silente. Presentamos dos casos en los que la indicación de cirugía se estableció en función de la edad -joven- de la paciente (caso número uno) y de la afectación del eje gonadal en un varón no subsidiario de tratamiento androgénico (caso número dos). Se discute el beneficio de incluir tales indicaciones quirúrgicas en el protocolo de evaluación de estas lesiones.

Palabras clave:
Incidentalomas hipofisarios
Macroadenomas hipofisarios
Tratamiento neuroquirúrgico
Summary

Pituitary macroadenomas (more than 10mm in diameter) are infrequent as casual findings and optimal management strategy for these tumours has not been established. Neurosurgical approach must be always considered in patients with visual field defects or with hormone-secreting adenomas (but prolactinoma), and in those with evidence of lesion's growth or if clinical pituitary apoplexy occurs. We present two cases in which surgical indication was based on patient's young age (case number one), and on hypogonadal status, in a male patient not suitable of androgen substitution (case number two). We also discuss the benefits of including such unusual indications for neurosurgical treatment into the incidentally discovered pituitary macroadenomas evaluation strategy.

Key words:
Pituitary incidentalomas
Pituitary macroadenomas
Neurosurgical treatment

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