Xiao Zhiyuan, Guo Xiaopeng, Yao Yong, Liu Jifang, Lian Wei, Deng Kan, Zhang Yu, Zhang Xia, Zhao Yuanli, Zhang Yi, Xing Bing, Zhu Huijuan
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Key Laboratory of Endocrinology of Ministry of Health, China Pituitary Adenoma Specialist Council, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
Int J Endocrinol. 2025 May 20;2025:1854208. doi: 10.1155/ije/1854208. eCollection 2025.
Management of pituitary neuroendocrine tumors (pitNETs) during pregnancy is challenging. Involvement of the multidisciplinary team (MDT) may benefit the collaborative decision-making. However, this aspect has not been well documented. We provided cases with pitNETs during pregnancy and summarized our experience on the MDT-guided management. We performed a retrospective study enrolling all pregnant patients with pitNETs treated at our institute between March 1995 and July 2024. During the indexed period, 121 patients with pitNETs consulted our institute during pregnancy, with 111 of them being treated conservatively and 10 undergoing surgery due to progressive visual defect and other symptoms. The age of the included surgical cases was 33 years, and the gestational session at surgery ranged from 13 to 36 weeks (1 in the first trimester, 4 in the second, and 5 in the third). Of the resected tumors, six were nonfunctioning and the other four were functioning (1 lactotroph, 1 somatotroph, and 1 thyrotroph). All surgical cases received MDT-guided management by physicians from neurosurgery, endocrinology, ophthalmology, obstetrics, pediatrics, and anesthesiology, leading to gross total tumor resection, improved visual acuity, and successful delivery in all patients. MDT guided management is essential for pitNETs during pregnancy. Surgical tumor resection is necessary for patients whose symptoms deteriorate rapidly. Transsphenoidal operation under general anesthesia is safe for pregnant patients with pitNETs.
孕期垂体神经内分泌肿瘤（pitNETs）的管理具有挑战性。多学科团队（MDT）的参与可能有助于协同决策。然而，这方面的记录并不充分。我们提供了孕期pitNETs的病例，并总结了我们在MDT指导管理方面的经验。我们进行了一项回顾性研究，纳入了1995年3月至2024年7月在我院接受治疗的所有孕期pitNETs患者。在索引期，121例孕期pitNETs患者到我院咨询，其中111例接受保守治疗，10例因进行性视力缺陷和其他症状接受手术治疗。纳入的手术病例年龄为33岁，手术时的孕周为13至36周（孕早期1例，孕中期4例，孕晚期5例）。切除的肿瘤中，6例为无功能肿瘤，其他4例为功能性肿瘤（1例催乳素瘤、1例生长激素瘤和1例促甲状腺激素瘤）。所有手术病例均接受了神经外科、内分泌科、眼科、产科、儿科和麻醉科医生的MDT指导管理，所有患者均实现了肿瘤全切、视力改善和成功分娩。MDT指导管理对孕期pitNETs至关重要。对于症状迅速恶化的患者，手术切除肿瘤是必要的。全身麻醉下的经蝶手术对孕期pitNETs患者是安全的。
