Silla turca vacía primaria (STVP): estudio de 117 casos

Introduccion: El termino Silla Turca Vacia Primaria (STVP) hace referencia a la invaginacion del espacio subaracnoideo hacia el interior de la silla turca en pacientes sin antecedentes de tumor, cirugia o radioterapia de la region selar. Aunque usualmente no esta asociado con disfunciones endocrinas, diferentes grados de hipopituitarismo e hiperprolactinemia han sido reportados. Objetivo: Analizar retrospectivamente datos clinicos, hallazgos radiologicos y bioquimicos de 117 pacientes con diagnostico de STVP. Pacientes y Metodos: Se estudiaron 117 pacientes, 98 mujeres (48 ± 14.9 anos). Los diagnosticos fueron realizados por Resonancia Magnetica Nuclear (n=115) y Tomografia Computada (n=2). La evaluacion de la funcion adenohipofisaria se realizo a traves de determinaciones hormonales basales. Resultados: Los motivos que llevaron al pedido de las imagenes fueron: cefaleas (35 %), sospecha clinica y/o bioquimica de deficiencia pituitaria (22 %), trastornos visuales (11 %), anormalidades de la radiografia simple de la silla turca (11 %), hiperprolactinemia (2,6 %), otros (18.4 %). El 48,9 % de las mujeres eran multiparas. Cefaleas, obesidad, hipertension arterial y autoinmunidad tiroidea fueron halladas en el 60, 67, 24,5 y 22,5 % de la poblacion evaluada respectivamente. Hiperprolactinemia ( Introduction: The term Primary Empty Sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in those patients with no history of pituitary tumor, neither surgery, nor radiotherapy. Though it is usually not associated with endocrine abnormalities, different degrees of hypopituitarism and mild hyperprolactinemia have been reported. Objective: To assess clinical features, radiological findings and biochemical endocrine function retrospectively from the records of 117 patients with diagnosis of PES. Patients and Methods: One hundred seventeen patients, 98 females, were studied. The mean age at diagnosis was 48 ± 14.9 yr. Most diagnoses were made with magnetic resonance imaging (n = 115), and only 2 through sellar computed tomography scan. Only pituitary basal hormones determinations were made, except for the TRH and ACTH tests which were performed for the diagnosis of primary hypothyroidism and secondary adrenal failure respectively. Results: Pituitary images were requested because of different reasons: headaches (35 %), clinical and biochemical suspicion of pituitary deficiency (22 %), visual disturbances (11 %), abnormalities on the simple sella turcica radiography (11 %) hyperprolactinemia (2.6 %), others (18.4 %): dizziness, seizures, rhinorrhea, loss of consciousness, skull trauma, galactorrhea. Multiple pregnancies were observed in 48.9 % of women; headaches, obesity, arterial hypertension and thyroid autoimmunity were found in 60 %, 67 %, 24.5 % and 22.5 % of the studied population respectively. Mild hyperprolactinemia (