SUMMARY The usual clinical presentation of non-functioning pituitary adenoma (NFPA) consists of symptoms of mass effect and hypopituitarism. NFPA is a rare condition in young women and an uncommon complication during pregnancy. We present the outcome of three patients with NFPA during pregnancy. Case 1: a 38-year-old woman was referred at 32nd week of spontaneous pregnancy because of diagnosis of a pituitary macroadenoma discovered in the context of progressive visual loss. Hormonal deficiency and hypersecretion were ruled out. Prolactin levels were high as expected. She developed diplopia and severe headache despite the use of dopamine agonists and corticosteroids, so pregnancy was interrupted at 34th week. After an uncomplicated delivery of a healthy newborn, transsphenoidal surgery was performed. The pathology was consistent with a gonadotroph adenoma. She recovered visual field, and remained with normal pituitary function. Postsurgical tumor remnant increased in size during the follow-up. Case 2: a 34-year-old woman was referred due to secondary amenorrhea and galactorrhea. A macroadenoma with suprasellar extension was discovered. Transsphenoidal surgery confirmed a gonadotroph adenoma. Two years after surgery she had a normal pregnancy. Six years after surgery a small tumor recurrence occurred. Case 3: a 23-year-old woman was referred due to a microincidental pituitary adenoma. Laboratory testing was normal. No findings on physical examination. A wait and see approach was decided. Two years after diagnosis, the patient got pregnant without complications. Image remained stable. This article may contribute new cases and provides an extensive review of NFPA during pregnancy.

Objetivo. Reportar 2 casos de pacientes con diagnóstico de síndrome de Tolosa-Hunt y realizar una revisión de la literatura de esta infrecuente patología. Descripción. Caso 1: Paciente femenina de 21 años de edad que consulto por oftalmoplejía dolorosa de 72 hs de evolución sin compromiso visual. Se realizó IRM de encéfalo que evidenció el engrosamiento difuso con realce postcontraste del seno cavernoso izquierdo. Se interpretó el cuadro como un STH. Caso 2: Paciente masculino de 45 años de edad que consultó por oftalmoplejía dolorosa de 2 meses de evolución y amaurosis del ojo derecho. Se le solicitó IRM de encéfalo que evidenció el engrosamiento difuso del seno cavernoso derecho. La retinografía evidenció la atrofia de la papila de dicho ojo. El cuadro se interpretó como un STH asociado a una neuritis óptica homolateral. Intervención. Caso 1. Inicio tratamiento con corticoides y carbemazepina lográndose a los 3 meses recuperación total sin recaídas posteriores. Caso 2. Se inicio tratamiento con corticoides. Actualmente se encuentra en control por consultorios presentando mejoría significativa de los síntomas sin mejoría de la amaurosis de ingreso. Conclusión. El STH es una entidad poco frecuente, con un probable origen autoinmunitario. Existen diversas causas que pueden simular este síndrome. Es mandatorio el análisis exhaustivo de estos pacientes, a fin de descartar otras patologías

Objective. We developed a bibliographic research of this rarely and highly aggressive entity, showing our experience and taking into account the special case of one patient, who developed an extremely aggressive disease. Description. Patient of 71 years that consults our department for left cavernous syndrome associated with moderate headache and bilateral visual accuracy diminish. Pituitary IRM was performed showing a homogeneous selar tumor that causes slight mass effect towards optic quiasm. Both cavernous sinuses were compromised. Intervention.Trasfenoidal surgery was performed, reaching the diagnosis of acidophil stem cell adenoma. The patient is dismissed. One week later and because of the development of sudden visual loss she was admitted once again. Pituitary IRM was performed showing a massive growth of the known lesion, requiring transcranial approach. Important mass reduction was achieved but our patient evolution was erratic. Three weeks after surgery we decided to repeat the IRM where we discovered the great mass reduction achieved in the second surgery did not reflect the voluminous lesion shown. One week later the patient died. Conclusion. Acidophil stem cell adenomas of the pituitary gland are mixed PRL/GH lesions, but because its immaturity non functional secreting hormones are produced; this is why these patients do not express physiognomic changes. We should think of this pathology in any pituitary tumor with low PRL-GH expression and few physiognomic changes, and aggressive natural evolution

Objectives: Presentation of two cases of a pathology of the skull base of very low frequency in world-wide literature Material and methods: First case: Male patient, 25 years old. The RMN of brain showed a lesion in selar, supra and paraselar location .Second case: female patient, 40 years old. The RMN of brain showed right temporal lesion with adjacent bone commitment. Results: Both patients were treated surgically, anatomopathologyic diagnosis was giant cells tumor (GCT). Conclusion: The GCT are generally benign, locally aggressive, the surgical excision has proved to be the most effective treatment. The presentation of this work is due to the scant bibliography reported until the moment on GCT of the skull base.