Vol. 12. Núm. 15.
Páginas 850-856 (Agosto 2016)

Actualización
Adenomas no funcionantes de la hipófisis

Nonfunctioning pituitary adenomas

A. García-ManzanaresaI. Gonzalo MontesinosbN. Gil FourniercJ. Álvarez Hernándezd
Doi : https://10.1016/j.med.2016.06.021
Opciones
Resumen
Epidemiología

Los adenomas no funcionantes de hipófisis (ANFH) son los macroadenomas hipofisarios más frecuentes.

 Etiopatogenia

La mayoría de ellos son secretores de gonadotropinas o subunidades inactivas, por lo que se caracterizan por no acompañarse de hipersecreción hormonal.

 Clínica

Su clínica es tardía por síntomas compresivos como la hemianopsia bitemporal, aunque con el aumento de realización de pruebas de imagen hoy en día la mitad de los diagnósticos se producen como incidentalomas.

 Diagnóstico

Su diagnóstico debe realizarse con resonancia nuclear magnética con gadolinio como contraste.

 Tratamiento

El tratamiento de elección es la resección quirúrgica transesfenoidal, pero es frecuente que la cirugía no sea curativa y se requiera tratamiento adicional como es la radioterapia, ya que los fármacos tienen escasa eficacia.

Palabras clave
Adenomas no funcionantes de hipófisis
Hemianopsia bitemporal
Cirugía transesfenoidal
Radioterapia esteroatáxica fraccionada
Abstract
Epidemiology

Nonfunctioning pituitary adenomas are the most common pituitary macroadenomas.

 Pathogenesis

Most of them secrete gonadotropin hormones or inactive subunits so are characterized by not accompanied by hormonal hypersecretion.

 Clinical manifestations

Performing its clinical belatedly by compression symptoms such as bitemporal hemianopsia, although with increased testing image today half of diagnosis occur as incidentaloma.

 Diagnosis

His diagnosis includes magnetic resonance imaging with gadolinium as contrast.

 Treatment

The fist choice treatment for these tumors is transsphenoidal surgical resection, but often surgery is not curative and futher treatment is required such as radiation therapy, because drugs have limited effectiveness.

Keywords
Nonfunctioning pituitary adenomas
Bitemporal hemianopia
Transsphenoidal surgery
Fractionated stereotactic radiation therapy

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