Protocolo diagnóstico de una lesión ocupante de espacio hipofisaria

Abstract

Space-occupying pituitary lesions are a common finding in imaging tests performed for the study of diseases not related to the pituitary gland, such as computed tomography (CT) or magnetic resonance imaging (MRI). Its prevalence varies between 10%-38% in radiological studies and 15% in autopsies. They are mostly pituitary adenomas (HA), classified according to size into microadenomas (< 10 mm) or macroadenomas (≥ 10 mm) and are usually benign and non-functional. Its management requires a multidisciplinary approach, including anamnesis, physical examination, pituitary hormonal profile to rule out hyperfunction or hypofunction, and ophthalmological studies. High-resolution pituitary MRI is the primary tool for evaluating these lesions and their impact on surrounding structures. The differential diagnosis is broad, and includes benign tumors, malignant tumors, cystic lesions, granulomatous diseases, infiltrative diseases, and vascular malformations. The growth of the lesion can compromise vision and even produce optic atrophy. Neuro-ophthalmological evaluation is essential to evaluate the degree of involvement and the indication for surgical treatment.