Tumores hipofisarios, casuística de Anatomía Patológica / Pituitary tumors: anatomopathological reports

This study examines a description of pituitary tumors considering an anatomopathological casuistic. The study of the tumors of the Central Nervous System (CNS) include the pituitary gland, located in the sella turcica. The pathology of the sellar region is represented by the adenomas, tumors of slow development with or without endocrine secretion, that usually involve the population of young adults. The aim of this report, was to describe the casuistic of the " J. Fernandez Hospital" between the years 2000 through 2017. A retrospective review was performed and 234 samples of the sellar region were processed. Mean age was 42 years with a range of 17 to 77 years. Sex distribution was 57% women and 43 % men. Of these, 77% of the cases resulted adenomas. The conclusions obtained in the study are detailed.

Evaluation of anterior pituitary function following traumatic brain injury

Neuroendocrine dysfunction following traumatic brain injury [TBI] is frequently missed due to the absence of major symptoms and very often, no appropriate management is prescribed, thus delaying the patient recovery. This study is aimed to determine the frequency and pattern of anterior pituitary dysfunction following TBI. From June to December 2009, over a period of seven months, a total of 156 cases were admitted to a trauma center following TBI. Of the seventy patients, [61 males and 9 females mean age 30 years] included in the study, 39 patients had moderate [GCS; 9 - 12] and 31 cases had severe [GCS < 8] TBI. Patients were tested 6 months after injury for possible secretory abnormalities of anterior pituitary hormones. Anterior pituitary secretary function was assessed by measurement of serum levels of FT4, TSH, basal GH, IGF-1, 8 am Cortisol, FSH, LH, total testosterone and prolactin. Dynamic tests of ACTH and glucagon stimulation were used to evaluate the pituitary-adrenal axis and GH secretory status. Forty-one patients [58.6%] were found to be suffering from at least one hormonal secretory abnormality, with patterns and frequencies of: Gonadotropins [LH, FSH], 12.9%, corticotrophin [ACTH], 12.9%, somatotropin [GH], 4.3%, and prolactin [PRL], 1.4%. There was no case with thyrotropin deficiency. Hyperprolactinemia was found to be present in 23 cases [31.5%]. The results of this study showed that anterior pituitary hormone deficiencies occur frequently, 6 months following traumatic brain injury. The two most commonly involved axes were the pituitary-gonadal and the pituitary-adrenal. Hypocortisolism may be particularly harmful for the patients' health

MRI findings in Kallmann syndrome.

Kallmann syndrome (KS) is a neuronal migration disorder characterised by hypogonadotrophic hypogonadism and anosmia or hyposmia. Five patients with clinical findings suggestive of KS were evaluated with MRI. All patients had abnormalities of olfactory system. Olfactory bulbs were absent in all patients. Olfactory sulci were absent in 3 patients and hypoplastic in 2 patients. Anterior pituitary was hypoplastic in two patients. The MRI findings in KS are characteristic and MRI is a useful adjunct to the diagnosis of KS.

Tratamento da acromegalia: resultados em 12 pacientes / Treatment of acromegaly: results in 12 patients

O resultado do tratamento da acromegalia foi avaliado numa serie de 12 pacientes. Em 4 deles foi obtido nivel de GH inferior a 5ng/ml. Este resultado foi alcancado em um caso atraves da cirurgia transesfenoidal e em 3 casos com cirurgia seguida de radioterapia. O seguimentos dos pacientes apos radioterapia ainda permite a obtencao do nivel desejado de GH em maior numero de casos. O resultado aqui obtido esta relacionado a altos niveis de GH na epoca do diagnostico e ao tamanho dos adenomas. Estes dados reforcam a importancia de diagnosticar precocemente esta patologia, para obtencao de melhor resultado terapeutico e diminuicao de sua morbidade

Significado de la concentración elevada de gastrina en pacientes con adenoma hipofisario / The significance of a high concentration of gastrin in patients with hipophyseal adenoma

Desde hace algún tiempo se ha venido tratando de modificar el concepto tradicional que define a una hormona: -un mensajero químico que producido por cierto tipo de células, navega por la circulación sanguínea hasta alcanzar a otra célula específica y distante, en donde ejerce su acción biológica-. En los últimos años se ha acumulado una enorme información que sustenta el concepto que la hormona es producida de manera ubicua y que no necesariamente tiene antes que "viajar" para ser reconocida por una gran variedad de células y que éstas son aparentemente inespecíficas. Es una ironía que la idea atrevida que formuló Starling a principio del siglo, resucite vigorosamente varia décadas después: Si, como estoy inclinado a creer, el crecimiento y actividad de todos los órganos del cuerpo están regulados por mecanismos químicos similares a los que he descrito; un mayor conocimiento de las hormonas y de su manera de acción, puede aclarar la forma como está controlado el cuerpo, el cual es la meta de la ciencia médica". De esta manera se conforma una imagen más cercana a la realidad fisiológica. Parece ser que el efecto de la hormona depende esencialmente de su estructura molecular, la cual se puede químicamente "metamorfiar", así como de su capacidad celular, expresada a través de sus receptores, para modular a ese mensajero. En 1954 Medawar bosquejó la teoría: "la evolución de la endocrinología no es una evolución de las hormonas, sino una evolución del uso para el cual se secreta la hormona: una evolución no de la estructura química, sino de la actividad biológica, de las reacciones y de la respuesta tisular". Otra contribución científica seminal consistió en la integración de los grandes sistemas que son responsables de conservar el equilibrio de medio interno, así los sistemas nervioso y endocrino actúan de manera concertada para mantener armónicamente todas las funciones vitales...