Clinical and laboratorial characterization and post-surgical follow-up of 87 patients with non-functioning pituitary macroadenomas Caracterização clínica e laboratorial e seguimento pós-cirúrgico de 87 portadores de macroadenomas hipofisários não funcionantes

• Main Authors: Paulo Andrade de Mello, Luciana Ansaneli Naves, Aldo Pereira Neto, Eduardo Henrique Oliveira, Ivan Coelho Ferreira, Antônio Santos de Araújo Júnior, Franz Jooji Onishi, Luiz Augusto Casulari
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO) 2013-05-01
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: neoplasia hipofisária; neurocirurgia; insuficiência; hormônio; adenomas hipofisarios; hipopituitarismo; pituitary neoplasms; neurosurgery; hormone; insufficient; pituitary adenomas; hypopituitarism
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000500307

Objective: It was to assess the main characteristics of patients undergoing pituitary tumor surgery. Method: Eighty-seven patients (44 men; 44.8&#177;13 years old) were included. Results: The main symptoms were visual alterations (87.3%), headache (70.1%), diminished libido (34.4%), galactorrhea (22.9%) and hair loss (19.5%). The axes affected were gonadotropic (72.6%), thyrotropic (48.4%) and corticotropic (38.7%), without significant changes after surgery. The average largest tumor diameter was 3.1 cm before surgery and 1.56 cm after surgery. The most frequent postoperative complications were hydro-electrolyte and acid-base disorders (12%), diabetes insipidus (9%), visual field alterations (9%), liquoric fistula (8%) and nasal obstruction (7%). The patients were affected by more than one complication. Conclusion: Although a decrease in tumor volume was achieved through surgery, hormonal deficiencies persisted in most of the patients and new surgical approaches were necessary for dealing with tumor recurrence or persistence.<br> Objetivo: Avaliar as principais caracter&#237;sticas de pacientes operados de tumor de hip&#243;fise. M&#233;todo: Foram inclu&#237;dos 87 pacientes (44 homens; 44,8&#177;13 anos). Resultados: Os principais sintomas foram altera&#231;&#245;es visuais (87,3%), cefaleia (70,1%), diminui&#231;&#227;o da libido (34,4%), galactorreia (22,9%) e queda de pelos (19,5%). Os eixos afetados foram gonadotr&#243;fico (72,6%), tireotr&#243;fico (48,4%) e corticotr&#243;fico (38,7%). N&#227;o houve mudan&#231;as significativas ap&#243;s a cirurgia. A m&#233;dia do maior di&#226;metro do tumor foi 3,1 cm antes da cirurgia e 1,56 cm ap&#243;s a cirurgia. As complica&#231;&#245;es p&#243;s-cir&#250;rgicas mais frequentes foram dist&#250;rbios hidroeletrol&#237;ticos e &#225;cido-b&#225;sicos (12%), diabetes insipidus (9%), altera&#231;&#245;es do campo visual (9%), f&#237;stula liqu&#243;rica (8%) e obstru&#231;&#227;o nasal (7%). Ocorreu mais de uma complica&#231;&#227;o no mesmo paciente. Conclus&#227;o: Embora tenha obtido diminui&#231;&#227;o da massa tumoral com a cirurgia, as defici&#234;ncias hormonais persistiram na maioria dos pacientes e ocorreu necessidade de novas abordagens por recidiva ou persist&#234;ncia do tumor.