[Silent corticotroph adenomas: presentation of two cases that presented with pituitary apoplexy].
Among the group of pituitary adenomas surgically treated, about 25-30% are not associated with clinical or analytical findings of hormonal hypersecretion. The development of immunohistochemical techniques has allowed the demonstration of a subgroup of adenomas that show immunoreactivity against several hormones among the group of, apparently, non-functioning adenomas. This subgroup has been called silent adenomas. Silent adenomas positive for ACTH show a singular clinical picture and different from those adenomas producing Cushing's disease, as they present more frequently as macroadenomas, with more frequent pituitary apoplexy, invasion of cavernous or sphenoidal sinus and recurrences. We present two new cases of silent corticotroph adenomas in two female patients that presented with pituitary apoplexy, one of them after giving birth after a normal full-term pregnancy. Both of them presented with macroadenomas that invaded the sphenoidal and cavernous sinus. Although both tumors were immunoreactive for ACTH, none of the patients presented clinical or analytical findings compatible with Cushing's disease.
Lagares
A
A
Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid. algadoc@yahoo.com
González
P
P
Miranda
P
P
Cabrera
A
A
Lobato
R D
RD
Ramos
A
A
Ricoy
J R
JR
D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
D000324:Adrenocorticotropic Hormone