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Vol. 6. Issue 3.
Pages 222-226 (January 1995)
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Vol. 6. Issue 3.
Pages 222-226 (January 1995)
Enfermedad de Cushing en la infancia. Tratamiento quirúrgico
J.M. Coca, J.I. Díaz de Tuesta, F. San Emeterio, R. Sarabia, J.M. Izquierdo
Servicio de Neurocirugía. Hospital Universitario. Valladolid
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Resumen

Se presentan tres pacientes con Enfermedad de Cushing, que fueron intervenidos. Los tres casos fueron estudiados desde el punto de vista endocrinológico y radiológico mediante Rx, TC y/o RM.

En los tres pacientes se efectuó abordaje a la silla turca por vía transesfenoidal, confirmándose anatomopatológicamente como adenomas productores de ACTH los dos primeros casos, siendo el tercero considerado por los anatomopatólogos como material insuficiente.

Se ha efectuado un seguimiento de nueve años para los dos primeros y cinco años para el tercero.

Se ha conseguido en los tres casos una mejoría espectacular no sólo desde el punto de vista endocrinológico sino también desde el punto de vista fisonómico. El hecho de la no recurrencia de la enfermedad, nos hace confirmar su origen hipofisario, por lo que nos declaramos partidarios de la cirugía transesfenoidal en los casos diagnosticados de Enfermedad de Cushing.

Palabras clave:
Enfermedad de Cushing en infancia
Transesfenoidal
Adenoma hipofisario
Summary

The authors present three children with Cushing's disease who underwent operation by a transesphenoidal approach. AH the three patients were studied both endocrinologically and radiologically with X-ray, computerised tomography or magnetic resonance.

The surgical findings were positive in two patients, in whom a pituitary adenoma was found, and negative in one case. Follow-up after operation is nine years for the two patients with adenoma and five years for the patient without apparent pathology. In all the three patients a favourable clinical and endocrinological result has been obtained. The authors favour transesphenoidal exploration of the pituitary gland in patients diagnosed of Cushing's disease.

Key words:
Cushing disease
Pituitary adenoma
Transesphenoidal approach

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