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- ItemAcesso aberto (Open Access)Adenomas hipofisários não secretantes: Estudo de 36 casos(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio de [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Aguiar, Paulo Henrique; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de Neurocirurgia; Universidade de São Paulo (USP)We present our experience with 36 cases of nonfunctional pituitary adenomas. These tumors were divided into non reactive and inactive in agreement with the immunohistochemical study. They present with visual symptoms, mainly bitemporal hemianopsia; they were macroadenomas, either invasive or non invasive, in both groups. The treatment is surgical using the transsphenoidal approach. Total resection was possible in about 40% of the cases. Visual improvement occurred in 90% of the patients.
- ItemAcesso aberto (Open Access)Adenomas produtores de GH: Análise de 20 casos(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio de [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Aguiar, Paulo Henrique; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de Neurocirurgia; Universidade de São Paulo (USP)The growth hormone secreting pituitary adenomas can be mono, bi or pluri-hormonals. The most frequent association of GH is with the sub unit alpha or with the prolactin. This type of adenoma comes with the classic alterations of acromegaly, but when they produce more than one hormone, visual symptoms can be present. The adenoma producing just GH hormone is generally microadenoma and the other two groups tend to be macroadenoma. We analyze 20 cases of these adenomas and we have found quite satisfactory surgical result for the mono-hormonal type group. Radiotherapy should be considered in cases of partial resection.
- ItemAcesso aberto (Open Access)Adenomas produtores de TSH: Relato de caso(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Prandini, Mirto Nelso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de NeurocirurgiaWe describe a rare case of thyroid-stimulating hormone-secreting pituitary adenoma in a patient with a clinical picture of hyperthyroidism, that developed bitemporal hemianopsia after four years of a known thyroid dysfunction. CT scan showed a pituitary tumor considered grade 2 and stage C according to Hardy-Vezina and Wilson. Treatment was surgical, initially by a transsphenoidal approach, in which only a biopsy was possible. The patient was then submitted to an orbital-pterional craniotomy with sub-total resection of the tumor. Complementary treatment was indicated with radiotherapy.
- ItemAcesso aberto (Open Access)Prolactinomas: Aspectos neurocirúrgicos(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Aguiar, Paulo Henrique; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de Neurocirurgia; Universidade de São Paulo (USP)We report our experience with 38 cases of prolactin secreting pituitary adenomas. The adenomas were divided in three different groups. The adenomas producing only prolactin tend to be microadenoma and they show the typical alterations of this type of tumor. The GH-PRL, GH-alpha subunit, the other combinations, and the pluri hormonal adenomas tend to present with visual symptoms. The treatment of the prolactinomas is initially clinical and the surgical indication for this type of adenomas is related to intolerance to the medication or to visual alterations. Surgical result with total resection of the tumor was possible in 50% of the cases.