SciELO - Scientific Electronic Library Online

vol.33 issue2Type I primary neuropathic amyloidosis (Andrade, Portuguese): a clinical and laboratory study of 21 casesNeuropathy in myotubular or centronuclear myopathy author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.33 no.2 São Paulo June 1975 

Microadenomas e adenomas hipersecretantes da hipofise, aspectos anátomo-radiológicos


Microadenomas and hypersecreting pituitary adenomas: radiographic aspects



Jean Lorrain VezinaI; Jules HardyII; Maciel YamashitaIII

IDepartamento de Neuroradiologia do Hospital Notre Dame e da Universidade de Montréal, Canadá
IIServiço de Neurocirurgia do Hospital Notre Dame e da Universidade de Montréal, Canadá
IIIMédico do Centro de Neuropsicocirurgia do Departamento de Neuro-Psiquiatria do Hospital das Clínicas da Universidade de São Paulo




São apresentados os primeiros sinais radiográficos de alteração selar encontrados nos casos de adenomas hipofisários hipersecretantes. O achado de duplo contôrno selar e de pequenas bosseladuras com o auxílio da tomografia selar tem permitido o diagnóstico da localização de microadenomas, a partir do que tem sido possível operar os pacientes no estágio inicial, quando o tumor não causou ainda lesões irreversíveis nos tecidos circunjacentes, o que facilita sobremaneira a cirurgia sem lesar o tecido hipofisário sadio, dando maiores possibilidades para o restabelecimento das funções hipofisárias ao normal.
É feita uma classificação anátomo-radiológica da sela túrcica em 4 estágios, que é de grande utilidade para o prognóstico cirúrgico pois observa-se a cura em mais de 90% dos casos no estágio 1, de 75% no estágio 2, de 50% no estágio 3 e de menos de 10% no estágio 4, na primeira cirurgia.


The early radiographic changes of the sella turcica in the cases of hypersecreting pituitary adenomas (Cushing disease, acromegaly, amenorrhea-galac- torrhea) are reported and discussed. The finding of the double contour of the sellar floor and the small crescentic bulging of its antero-inferior wall, with the aid of the tomographic cuts of the sella, has permited the diagnosis of the microadenoma's localization. With this it is possible the achievement of a seletive excision of the lesion in the initial stage, when the tumor has not caused yet irreversible damage to the inside normal pituitary tissue. This surgery is perfomed in the precocious stage with the primary goal to preserve the normal gland, without hurt it to avoid postoperative hipopituitarism.
A anatomo-radiologic classification of the alterations sella turcica in 4 grades is made, which is of great utility for the surgical prognostic, since we have observed clinical and biological cure over 90% in the grade 1, 75% in the grade 2, 50% in the grade 3 and up to 10% in the grade 4 in the first surgery.



Texto completo disponível apenas em PDF.

Full text available only in PDF format.




1. BAKER, H. L. — The angiographic delineation of sellar and parasellar masses. Radiology 104:67, 1972.         [ Links ]

2. CAPLAN, R. H. & DOBBEN, G. D. — Endocrine studies in patients with the empty sella syndrome. Arch. Int. Med. 123:611, 1969.         [ Links ]

3. DAVIES, D. O. — Neuroradiological diagnosis of sellar and parasselar lesions. Clin. Neurosurg. 17.160, 1970.         [ Links ]

4. FRIESEN H.; WEBSTER R.; HWANG P.; GUYDA H.; MUNRO R. E. & READ, L. — Prolactin synthesis and secretion in patients with Forbes-Albright syndrome. J. Clin. End. & Metab. 34:192, 1972.         [ Links ]

5. GORDON, D. A.; HILL, F. M. & EZRIN, C. — Acromegaly: a review of 100 cases. Can. Med. Ass. J. 87:1106, 1962.         [ Links ]

6. GUIOT, G. & DEROME, P. — Les indications de la voie d'abord trans-sphénoidale en Neuro-chirurgie. Ann. Méd. Int. 123:703, 1972.         [ Links ]

7. HARDY, J. — Transsphenoidal surgery of hypersecreting pituitary tumors. In: Diagnosis and Treatment of Pituitary Tumors. Edit. by Kohler, P. O. & Ross, G. T. Excerpta Medica, Amsterdam, 1973, pág. 179.         [ Links ]

8. HARDY, J. — Traitement chirurgical de l'adénome hypophysaire. Neurochirurgie (Paris) 19: suppl. 2:75, 1973.         [ Links ]

9. HARDY, J. — Transsphenoidal hypophysectomy. J. Neurosurg. 34:581, 1971.         [ Links ]

10. HARDY, J. — Microchirurgie des adénomes hypophysaires hypersécrétants. In: Les Adénomes Hypophysaires Sécrétants. Masson et Cie., Paris, 1971, pág. 195.         [ Links ]

11. HOFELDT, F. D.; LEVIN, S. R.; SCHNEIDER, V.; BECHER, N. & FORSHAM, P. — Clinical features of acromegaly and response to cryohypophysectomy. Rocky Mt. Med. J. 70:21 — Sept./73.         [ Links ]

12. KAUFMAN, B. & CHAMBERLAIN Jr., W. B. — The ubiquitous empty sella turcica. Acta Radiol. (Diagn.) 13:413, 1972.         [ Links ]

13. KRAMER, S. — The hazards of the therapeutic irradiation of the central nervous system. Clin. Neurosurg. 15:301, 1968.         [ Links ]

14. McLAHLAN, M.; WRIGHT, A. D. & DOYLE, F. D. — Plain film and tomographic assessment of the pituitary fossa in 140 acromegalic patients. Brit. J. Radiol. 43:360, 1970.         [ Links ]

15. NEELON, F. A.; COREE, J. A. & LEBOVITZ, H. E. — The primary empty sella. Clinical and radiographic characteristics and endocrinal function. Medicine (Baltimore) 52:73, 1973.         [ Links ]

16. RADBERG, C. — Some aspects of asymmetric enlargement of sella turcica. Acta Radiol. (Diagn.) 1:152, 1963.         [ Links ]

17. SCHALCH, D. S. & PARKER, M. L. — A sensitive double antibody in immunoassay for human growtn hormone in plasma. Nature (London) 203:1141, 1964.         [ Links ]

18. VÉZINA, J. L. & SUTTON, T. J. — Prolactin-secreting pituitary microadenomas: roentgenologic diagnosis. Am. J. Roentg. R. T. & N. M. 120:46, 1974.         [ Links ]

19. VÉZINA, J. L. & MALTA IS, R. — La selle turcique dans l'acromégalle: étude radiologique. Neurochirurgie (Paris) 19: suppl. 2, pág. 33, 1973.         [ Links ]

20. ZATZ, L. M.; JANON E. A. & NEWTON, T. H. — The enlarged sella and the intrasellar cistern. Radiology 93:1085, 1969.         [ Links ]



Dr. Jean Lorrain Vézina adress: Hôpital Notre Dame — 1560 Est. Sherbrooke — Montréal — Canadá.

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License