Mehta Gautam U, Lonser Russell R
Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Neuro Oncol. 2017 Jun 1;19(6):762-773. doi: 10.1093/neuonc/now130.
Pituitary adenomas are one of the most common primary central nervous system tumors and have an estimated prevalence of 17%. Approximately half of pituitary adenomas secrete distinct pituitary hormones (most often prolactin, growth hormone, or adrenocorticotropic hormone). While these tumors are histologically benign, they have potent endocrine effects that lead to significant morbidity and shortened lifespan. Because of their pathophysiologic endocrine secretion and anatomic location near critical neural/vascular structures, hormone-secreting pituitary adenomas require defined management paradigms that can include relief of mass effect and biochemical remission. Management of hormone-secreting pituitary adenomas involves a multidisciplinary approach that can incorporate surgical, medical, and/or radiation therapies. Early and effective treatment of hormone-secreting pituitary adenomas can reduce morbidity and mortality. Consequently, understanding clinical features as well as therapeutic options in the context of the specific biological features of each type of hormone-secreting pituitary adenoma is critical for optimal management.
垂体腺瘤是最常见的原发性中枢神经系统肿瘤之一,估计患病率为17%。大约一半的垂体腺瘤分泌特定的垂体激素(最常见的是催乳素、生长激素或促肾上腺皮质激素)。虽然这些肿瘤在组织学上是良性的,但它们具有强大的内分泌作用,会导致严重的发病率和缩短寿命。由于其病理生理内分泌分泌以及靠近关键神经/血管结构的解剖位置,分泌激素的垂体腺瘤需要明确的管理模式,其中可能包括减轻占位效应和生化缓解。分泌激素的垂体腺瘤的管理涉及多学科方法,可包括手术、药物和/或放射治疗。早期和有效地治疗分泌激素的垂体腺瘤可降低发病率和死亡率。因此,了解每种类型分泌激素的垂体腺瘤的临床特征以及在其特定生物学特征背景下的治疗选择对于优化管理至关重要。