adenoma_de_hipofisis_pronostico

Adenoma de hipófisis pronóstico

Son lesiones benignas, si bien aproximadamente el 5% de estos tumores tienen un curso clínico más agresivo.

Tasa de recidiva del 20 % a pesar de una resección aparentemente completa y que depende de su característica histológica especialmente los acidófilos, los adrenocorticotrópicos, oncocitomas, plurihormonales y tumores con indices proliferativos inusualmente altos.

Una de las características más desfavorables y que representa la principal causa de resección quirúrgica incompleta es la invasión del seno cavernoso.

Prolactinomas.- La mortalidad quirúrgica en series recientes es<0.5% y curaciones de prolactinomas a largo plazo > del 74%. Resultados similares al tratamiento médico pero evitando los efectos secundarios del tratamiento médico.

Acromegalia

El embarazo en pacientes con acromegalia es un evento poco frecuente, debido a la función perturbada de gonadotropos. Por otra parte, el embarazo puede provocar un aumento del tamaño del adenoma o un aumento de la secreción de la hormona del crecimiento (GH). en En mujeres jóvenes bien controlados con tratamiento médico el embarazo no suele influir en la acromegalia (Ben Salem 2009).

Bibliografía

Ben Salem Hachmi L, Kammoun I, Bouzid C, Smida H, Nagi S, Turki Z, Ben Slama C. [Management of acromegaly in pregnant woman.]. Ann Endocrinol (Paris). 2009.

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Carri NG, Sosa YE, Brown OA, Albarino C, Romanowski V, Goya RG: Studies on in vivo gene transfer in pituitary tumors using herpes-derived and adenoviral vectors. Brain Res Bull 65:17-22, 2005.

Couldwell WT, Cannon-Albright L. A heritable predisposition to pituitary tumors. Pituitary 2009.

Freda PU, Reyes CM, Nuruzzaman AT, Sundeen RE, Khandji AG, Post KD: Cabergoline therapy of growth hormone & growth hormone/prolactin secreting pituitary tumors. Pituitary 7:21-30, 2004.

Furtado SV, Saikiran NA, Ghosal N, Hegde AS. Giant, solid, invasive prolactinoma in a prepubescent boy with gynecomastia. Pediatr Neurol. 2010 Jan;42(1):72-4.

Gonzalez-Gonzalez JL, Lopez-Arbolay O, Morales-Sabina O, Marti-Pineiro JF, Vidal-Verdial R: [Transnasal-transsphenoidal endoscopic surgery of the sellar region]. Neurocirugia (Astur) 16:27-33, 2005.

Jane JA, Jr., Vance ML, Woodburn CJ, Laws ER, Jr.: Stereotactic radiosurgery for hypersecreting pituitary tumors: part of a multimodality approach. Neurosurg Focus 14:e12, 2003.

Knappe UJ, Engelbach M, Konz K, Lakomek HJ, Saeger W, Schönmayr R, Mann WA.Ultrasound-assisted Microsurgery for Cushing's Disease. Exp Clin Endocrinol Diabetes.

Koutourousiou M, Kontogeorgos G, Seretis A. Non-adenomatous sellar lesions: experience of a single centre and review of the literature. Neurosurg Rev. 2010 May 18. [Epub ahead of print] PubMed PMID: 20480381.

Kreutzer J, Fahlbusch R: Diagnosis and treatment of pituitary tumors. Curr Opin Neurol 17:693-703, 2004.

Liu JK, Schmidt MH, MacDonald JD, Jensen RL, Couldwell WT: Hypophysial transposition (hypophysopexy) for radiosurgical treatment of pituitary tumors involving the cavernous sinus. Technical note. Neurosurg Focus 14:e11, 2003.

McCord MW, Buatti JM, Fennell EM, Mendenhall WM, Marcus RB, Jr., Rhoton AL, Grant MB, Friedman WA: Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys 39:437-444, 1997.

National Cancer Institute – Pituitary Tumors Treatment. Available: http://www.cancer.gov/cancertopics/pdq/t​reatment/pituitary/HealthProfessional/pa​ge1/AllPages#1. Accessed 2012 Nov 13.

Oh, Min Chul, Eui Hyun Kim, and Sun Ho Kim. 2012. “Coexistence of Intracranial Aneurysm in 800 Patients with Surgically Confirmed Pituitary Adenoma.” Journal of Neurosurgery 116 (5) (May): 942–947. doi:10.3171/2011.12.JNS11875.

Pollock BE, Carpenter PC: Stereotactic radiosurgery as an alternative to fractionated radiotherapy for patients with recurrent or residual nonfunctioning pituitary adenomas. Neurosurgery 53:1086-1091; discussion 1091-1084, 2003.

Rudnik A, Zawadzki T, Wojtacha M, Bazowski P, Zubgaluszka-Ignasiak B, Duda I: [Endoscopic transsphenoidal treatment of pituitary adenomas.]. Neurol Neurochir Pol 39:17-23, 2005.

Sandoval-Sánchez, J H, F Flores-Cárdenas, M C Vargas-Frutos, y J M Páez-Ontiveros. 2007. «[Complications of the direct endonasal transsphenoidal approach in the management of pituitary adenomas]». Neurocirugía (Asturias, Spain) 18 (6) (Diciembre): 485-491.

Sasagawa, Yasuo, Osamu Tachibana, Shunsuke Shiraga, Hisasi Takata, Takuya Akai, and Hideaki Iizuka. 2012. “[A Clinical Feature and Therapeutic Strategy in Pituitary Adenomas Associated with Intracranial Aneurysms].” No Shinkei Geka. Neurological Surgery 40 (1) (January): 15–21.

Sheehan JM, Vance ML, Sheehan JP, Ellegala DB, Laws ER, Jr.: Radiosurgery for Cushing's disease after failed transsphenoidal surgery. J Neurosurg 93:738-742, 2000.

Sinha, Sumit, y B S Sharma. 2010. Giant pituitary adenomas–an enigma revisited. Microsurgical treatment strategies and outcome in a series of 250 patients. British Journal of Neurosurgery 24, no. 1 (Febrero): 31-39. doi:10.3109/02688690903370305.

Wasko R, Waligorska-Stachura J, Jankowska A, Warchol JB, Liebert W, Sowinski J. Coexpression of survivin and PCNA in pituitary tumors and normal pituitary. Neuro Endocrinol Lett. ;30(4)2009.

Witt TC: Stereotactic radiosurgery for pituitary tumors. Neurosurg Focus 14:e10, 2003.

Yamada, So, Shoko M Yamada, Toshio Hirohata, Yudo Ishii, Katsumi Hoya, Mineko Murakami, and Akira Matsuno. 2012. “Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm.” Case Reports in Neurological Medicine 2012: 891847. doi:10.1155/2012/891847.

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