[Hormonal dysfunction of nonpituitary lesions from midline and perisellar area].
OBJECTIVE
To analyse clinical and/or laboratorial preoperative hormonal dysfunction, of the nonpituitary intracranial lesions from midline and parasellar area.


METHODS
Forty-four patients were evaluated with nonpituitary intracranial lesions, who had images studies (computed tomography or magnetic resonance) and preoperative basal hormonal level; 16 had preoperative hypothalamus-hypophysial function tests (megatests). These patients were divided in two groups. Group I - 34 lesions from midline: 11 craniopharyngiomas, 8 meningiomas, 3 germinomas, 3 tumors of sphenoid sinus, 2 empty sella syndrome, 2 pylocitic astrocytomas, 1 giant aneurysm, 2 mucoceles, 1 III ventricle diverticulum and 1 Rathke's cleft cyst; Group II - 10 lesions from parasellar area: 9 meningiomas and 1 giant aneurysm.


RESULTS
In group I, 25/34 (73.5%) patients showed laboratorial hormonal deficit (14 without clinical manifestations) 18/34 (52.9%) hyperprolactinemia (5 with galactorreia) and 8 (53.3%) showed growth hormone deficiency in 15 megatests available in this group; 3 (8.8 %) patients presented central diabetes insipidus (CDI). In group II, 6/10 (60%) patients showed laboratorial hormonal deficit (5 without clinical manifestations), 1 (10%) hyperprolactinemia and 1 growth hormone deficiency (single megatest realized in this group); no patient had preoperative CID.


CONCLUSIONS
The presence of nonspecific or poorly valorized clinical manifestations, does not indicate absence of hormonal dysfunction; in this present serie, 19/38 (50%) patients with laboratorial abnormalities, didn't show clinical manifestations. Hormonal dysfunction is frequent in sellar and perisellar nonpituitary lesions, specially involving midline.
Fonseca
A L
AL
Serviço de Neurocirurgia, Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Souto
A A
AA
Domingues
F
F
Vaisman
M
M
Gadelha
M R
MR
Chimelli
L
L
Santos
M J
MJ
Violante
A H
AH
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003397:Craniopharyngioma / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007027:Hypothalamic Diseases / Q000097:blood; D008297:Male; D008577:Meningeal Neoplasms / Q000097:blood; D008579:Meningioma / Q000097:blood; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood*; D011388:Prolactin; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood
D006728:Hormones; D013739:Testosterone; D004958:Estradiol; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D013006:Growth Hormone; D006854:Hydrocortisone