Browsing by Author "Jimenez Encalada, Marcia Gabriela"

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    Adenomas hipofisarios: características sociodemográficas, clínicas y terapéuticas de 250 casos
    (2021) Barahona Ulloa, Wilson Fabricio
    Introduction and objective: Pituitary adenomas are present in 23% of the general population, being mainly small and asymptomatic. Despite the existence of global and regional data, in Ecuador there are no large-scale records on this pathology. The objective of this study is to descriptive diagnosed pituitary tumors ́socio-demography, clinical, and therapeutic features over a 5-years period in one of the most important specialty hospitals in the country. Materials and methods: An observational study with descriptive design was performed. Data from clinical records of patients with a definitive diagnosis of pituitary adenoma that have been treated from January 1, 2012 to December 31, 2016 were collected at the specialty hospital José Carrasco Arteaga. Results: There were 250 cases with pituitary adenomas, 179 women (71,6%), 126 (50,4%), adults. The most frequent diagnostic age was between 20 and 39 years. The microadenoma was observed in 164 times (65,6%). The clinical presentation was mostly symptomatic in 225 people (90%). Excess hormonal production was detected in 176 patients (70,4%). Prolactinoma was the most common subtype, 146 (58,4%). The most used treatment was pharmacological, in 200 cases (80%). Conclusions: The results are similar to the literature reviewed, although in this study the symptomatic presentation prevailed mostly over the incidental form and the percentage difference between female and male was greater, especially among non-functioning subtypes.
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    Endoscopic endonasal approach for pituitary adenomas: results from a multidisciplinary management
    (2021) Jimenez Encalada, Marcia Gabriela
    Abstract Background Endoscopic endonasal approach (EEA) has gained increasing acceptance in the world; however, pituitary adenomas require multidisciplinary management for good outcomes. The aim of this study is to report the results of this management of a consecutive series of patients who underwent a purely endoscopic endonasal approach for pituitary adenomas resection in our hospital and compare them to other series. Methods A retrospective review of clinical and radiographic records of 80 consecutive patients with pituitary adenomas who were operated on using an EEA between 2011 and 2019 was performed. The patientś clinical, ophthalmologic, endocrinologic and radiographic outcomes were evaluated. Results 57% were women and 43% men. The age ranged from 10 to 79 years. 72 tumours (90%) were macroadenomas; in 19 patients (23.75%) the cavernous sinus was invaded. There were 58 non-functioning adenomas and 17 growth hormone secreting, 4 prolactin-secreting, and 1 thyroid-stimulating hormone-secreting adenomas. Gross total resection was achieved in 76.2% of tumours without cavernous sinus invasion. Of the 53 patients presenting with visual loss, 47 (88.6%) improved or normalized. The remission rates with EEA alone were 58% in the GH-secreting adenomas and 75% in the prolactinomas group. Complications included CSF leak in 12.5%, new hormonal deficit in 18.75%, epistaxis in 6.25%, sella hematoma in 3.75% and neuroinfection in 1 patient (1.25%). We did not have mortality. The follow-up was from 6 to 87 months. Conclusions A multidisciplinary management is required for the adequate treatment of pituitary adenomas. With good surgical training, the EEA is safe and effective around the world. Our results are similar compared with those reported in previous series of microscopic or endoscopic approaches.
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