Hlaváč M, Sommer F, Karpel-Massler G, Wirtz R, Hoffmann T, Paľa A
Klinik für Neurochirurgie, Universität Ulm, Albert-Einstein-Allee 23, 89075, Ulm, Deutschland.
Klinik für Hals-Nasen-Ohrenheilkunde, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
HNO. 2019 Apr;67(4):307-318. doi: 10.1007/s00106-019-0629-3.
Pituitary adenomas are among the most common primary brain tumors. These tumors can produce all hormones of the anterior pituitary and thus cause endocrine diseases. Compression of the pituitary gland, the surrounding cranial nerves, or brain structures can lead to hypopituitarism, cranial nerve deficits, or diverse neurological symptoms. Visual impairment, typically with bitemporal hemianopsia, is the most common cardinal symptom. The diagnostic workup requires broad interdisciplinary cooperation. With the exception of prolactinoma, the treatment of choice for symptomatic pituitary adenoma is transnasal transsphenoidal resection. For prolactinoma, dopamine agonistic therapy is the primary treatment. Adequate hormone replacement therapy is essential in cases of hypopituitarism. Long-term follow-up is a vital part of the treatment concept.
垂体腺瘤是最常见的原发性脑肿瘤之一。这些肿瘤可分泌腺垂体的所有激素,从而引发内分泌疾病。垂体、周围颅神经或脑结构受压可导致垂体功能减退、颅神经功能缺损或各种神经症状。视力损害,通常为双颞侧偏盲,是最常见的主要症状。诊断检查需要广泛的多学科合作。除泌乳素瘤外,有症状的垂体腺瘤的首选治疗方法是经鼻蝶窦切除术。对于泌乳素瘤,多巴胺激动剂治疗是主要治疗方法。垂体功能减退的病例中,充分的激素替代治疗至关重要。长期随访是治疗理念的重要组成部分。