Pituitary adenoma - a group of tumors originating in the brain department - adenohypophysis. Pituitary adenoma up to 10% of all intracranial tumors. More often than not they are in the age of 30-40 years old, equally often in men and women.
By providing pituitary adenoma size: mikroadenomy (less than 1 cm in maximum dimension) makroadenomy.
For hormonal functions: hormone
-dormant pituitary adenoma hormone
-active pituitary adenoma (prolaktinoma
- produces prolactin, kortikotropinoma
- produces adrenocorticotropic hormone, somatotropinoma - produces somatotropny hormone, tirotropinoma
- a very rare tumor, thyroid-stimulating hormone identifies, develops gonadotropinoma luteinizing hormone and / or follicle-stimulating hormone).
The manifestations of pituitary adenoma The manifestations of pituitary adenoma depends on the hormonal functions of the tumor. When hormone-active ADENOMA main manifestations
- specific hormonal disorders. When hormone-inactive ADENOMA patients often turn to complaints of violations of (often narrow fields and the reduction of visual acuity), and headaches. The rare display of a large pituitary adenoma
- a sharp attack headaches, a sharp narrowing of fields and drop visual acuity, with involvement in the special department of the brain - hypothalamus
- of consciousness. Diagnosing pituitary adenoma: hormonal and thorough ophthalmologic examination and neyrovizualizatsiya. Magnetic resonance imaging - the main method of diagnosis, reveals adenoma size of less than 5 mm, but even with this in mind, about 25-45% of patients are unable to visualize adenomas.
Computer tomography used only in emergency situations when it is not possible to conduct MRI for the exclusion of severe complications. Treatment of pituitary adenoma Drug therapy of pituitary adenoma include: agonists dofamina (bromokriptin, kabergolin) analogues somatostatina (oktreotid) serotonin antagonists inhibitors produce cortisol Surgical treatment of pituitary adenoma: options transsfenoidalnogo (most often used at present) and transcranial (with giant suprasellyarnyh ADENOMA) tumor removal. Radiation therapy conducted as auxiliary treatment. It should be noted that for each type of tumor there is a specific, the best tactic treatment. It must be remembered that the majority of patients should be treated in specialized medical centers under the supervision of endocrinology, and a neurosurgeon. Prolaktinoma The concentration of prolactin, more than 500 ng / ml - shows the drug therapy The concentration of prolactin less than 500 ng / ml - shows the surgical treatment the concentration of prolactin, more than 500 ng / ml, but the tumor does not respond or insufficiently responsive to therapy - surgery is shown, followed by the continuation of drug therapy Somatotropinoma In the course of asymptomatic patient older shows drug therapy (bromokriptin, oktreotid) In all other cases, with no contraindications for surgical treatment shown surgery In continuing operations, after high concentrations of hormone somatotropnogo, recidivism tumor or after radiation therapy showed continued drug therapy Kortikotropinoma The method of choice for all «candidates» for surgical treatment - removing mikroadenomy. Recovery were observed in 85% of patients If you have a contraindication for rapid intervention by conducting drug and / or radiation therapy Hormone-inactive pituitary adenoma (more makroadenomy).
The method of choice for all «candidates» for surgical treatment - to remove the tumor. Radiation therapy conducted in the presence of inaccessible remove residual tumor or with inoperable relapse. The forecast in the pituitary adenoma The forecast is largely dependent on the size of the tumor (the possibility of radical removal) and hormonal functions. When prolaktinomah and somatotropinomah "hormonal" recovery seen in 20-25% of cases in mikrokortikotropinomah - 85% of cases (with tumors larger than 1 cm - much less often). It is believed that makroadenomu pituitary the spread of more than 2 cm can not be removed completely, so in the next 5 years after surgery may experience a relapse.
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