What is adenoma pituitary? How diagnostics and treatment of pituitary adenoma? Answers to these questions you will find in the article.
Content
Adenoma pituitary gland
Adenoma pituitary - a group of tumors originating from the brain department - adenogipofoff.
The adenoma of the pituitary is up to 10% of all intracranial tumors. Most often
They appear at the age of 30-40, equally often in men and women.
According to the dimensions of the adenoma, the pituitary is distinguished:
- Microenomes (less than 1 cm in maximum measurement),
- Macroenaceans.
By hormone function:
- Hormonal-inactive pituitary adenoma
- Hormonally active
Adenoma pituitary gland (prolactinoma - produces prolactin,
Corticotropinoma - produces adrenocorticotropic hormone,
Somatotropinoma - produces a somatotropic hormone, thyrotropin -
Extremely rare tumor, highlights thyrotropic hormone, gonadotropin
produces luteinizing hormone and / or follicle-stimulating
hormone).
The manifestations of the adenoma of the pituitary gland depend on the hormonal function of the tumor. With hormonally active
Adenomas main manifestations - specific hormonal violations.
With hormonally inactive adenomas, patients most often appeal to complaints
on visual impairment (most often the narrowing of fields and reduction of visual acuity) and the head
Pain. Rare manifestation of a large pituitary adenoma - a sharp attack of headaches, a sharp narrowing of fields and a fall
Acute view, when involving a special brain section - hypothalamus
Disorders of consciousness.
Diagnosis and treatment of pituitary adenoma
Diagnostics of the pituitary adenoma: thorough hormonal and ophthalmic surveys
and neurovalization. Magnetic resonance tomography The main diagnostic method allows you to identify the adenoma
dimensions less than 5 mm, however, even taking into account this, about 25-45% of patients
visualize adenoma is not possible. Computer tomography apply only
In emergency situations, if it is impossible to carry out magnetic resonance tomography to eliminate hard
Complications.
The drug therapy of the pituitary adenoma includes:
- Dopamine Agonists (Bromocriptine, Cabbergoline)
- Somatostatin analogues (octreotide)
- Serotonin antagonists
- Cortizola products inhibitors
Operational treatment of the pituitary adenoma: options for transfenoidal (most commonly used
Currently) and transcranial (with gigantic suprasellular adenomas)
Removal of the tumor.
Rauchery therapy is carried out as an auxiliary treatment.
It should be noted that for each type of tumors there is a specific, most
Optimal tactics of treatment.
It must be remembered that most patients should be treated in specialized
medical centers under the supervision of both an endocrinologist and neurosurgeon.
Prolactinoma
- The concentration of prolactin is more than 500 ng / ml - the drug therapy is shown
- Prolactin concentration of less than 500 ng / ml - Specific treatment is shown
- The concentration of prolactin is more than 500 ng / ml, but the tumor does not react or not enough
Reacts to therapy - the surgical intervention is shown followed by the continuation
Medicinal therapy
Somatotropinoma
- In the asymptomatic course, the elderly patient is shown the drug
Therapy (bromocriptine, octreotide)
- In all other cases, in the absence of contraindications to surgical
treatment shows surgical intervention
- With a high concentration of the somatotropic hormone continuing after surgery, tumor relapse
or after radiation therapy shows the continuation of drug therapy
Corticotropinoma
- Selection method for all «Candidates» for operational treatment - disposal of microenomes. The cure is observed in 85% of patients
- In the presence of contraindications to surgical intervention, medicinal
and / or radiation therapy
Hormonian-inactive pituitary adenomes (more often than macroenomes)
Selection method for all «Candidates» for operational treatment - tumor removal.
The radiation therapy is carried out in the presence of inaccessible removal of the tumor residues or
With inoperable recurrence.
radical removal) and its hormonal function. At prolactinum I
Somatotropinomas «Hormonal» Recovery is observed at 20-25%
Cases, with microcorticotropynes - in 85% of cases (with tumors
more than 1 cm - much less often). It is believed that macroen
The pituitary with the distribution of more than 2 cm can not be removed completely,
Therefore, over the next 5 years after surgery, it may occur
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