Pituitary adenoma

Overview pituitary tumor is a group from the anterior and posterior cranial pharynx and the residual epithelial cells of the tumor, intracranial tumor about 10%. It may occur at any age, was particularly prevalent in the 40 -50 years old. Categories : 1. Functional (secretory) pituitary tumors, including prolactin tumor, tumor growth hormone, ACTH tumor, Nelson syndrome (ACTH-MSH tumor), thyroid-stimulating hormone tumor, mixed adenoma. 2. Non-functional (non-secretory) pituitary tumor "chromophobe tumor cells", accounting for 20-35%. Symptoms of functional pituitary tumors are more characteristic of their clinical symptoms, pituitary microadenomas (diameter "10mm) can cause hyperthyroidism, such as excessive growth hormone cause acromegaly; ACTH caused excessive Cushing's disease; Prolactin excessive caused galactorrhea, amenorrhea, impotence. Non-functional pituitary tumors are often in larger tumors, oppression optic chiasm, pituitary or hypothalamus, headache, visual disturbance, visual field defect. amenorrhea, such as impotence and corresponding symptoms was found. Censorship (1) Determination of hormones : the vast majority of functional pituitary tumors often single hormone secretion, anterior pituitary hormone and target Hormone Determination made in the early diagnosis. It should however be noted that : (a) the basis of pituitary hormones vulnerable to internal and external value of the environment, drugs and the rhythm cycle; (2) single pituitary adenoma, elevated blood hormone may not limited to one, this phenomenon does not necessarily mean that the mixed adenoma, Unless the two hormones were significantly higher; (3) Hormones and adenoma size and clinical symptoms may not be parallel, The latter depends on the length of the course, the type of hormone, whether the tumor and cystic degeneration, and other changes affecting the activity of hormones and other substances. Hormone Determination should therefore repeated and, if necessary, to make the hormone excitation and inhibition experiments. (2) Diagnosis : 1. Sella X-ray examination, pituitary tumors larger films can be seen Sella expand, saddle underneath shift On back bone destruction. 2. Pituitary CT scan, 3mm diameter can be found above the microadenoma. 3. NMR right pituitary tumor is very precise positioning. (3) Determination of vision : The vision of regular is conducive not only to diagnosis, prognosis able to follow-up observation. Sella diagnosis of pituitary tumors should expand except empty sella, which Sella spherical expansion, no bone damage, CT can be diagnosed. Non-functional pituitary tumor required attention except parasellar a variety of illnesses, such as pituitary tumor, inflammatory, degenerative and hemangioma. According to the treatment of adenoma nature and size of the tumor, treated by surgery, radiation therapy and (or) drug treatment. (1) Surgical treatment : In addition prolactinoma, should first consider the early operation. (2) Radiation Therapy : suitable for small tumors, no saddle, saddle and other erosion foreign oppression, After surgical treatment ineffective or unwilling to surgical treatment, can also be used for post-operative adjuvant radiotherapy. In recent years, application of x-knife, γ - Knife stereotactic radiotherapy. (3) Drug treatment : Available Bromocriptine (dopamine beta-agonist) in the treatment of prolactinoma, acromegaly; cyproheptadine (inhibited serum - stimulated CRH) in the treatment of Cushing's disease; somatostatin analogue octreotide in the treatment of acromegaly and TSH tumor. Or adenomas after surgical resection combined with radiotherapy or drug treatment.