Martin M C, Schriock E D, Jaffe R B
West J Med. 1983 Nov;139(5):663-72.
Prolactin-secreting pituitary adenoma is a common cause of gynecologic problems that include oligomenorrhea, infertility, amenorrhea and galactorrhea. Diagnosis requires a combination of endocrine testing and radiologic evaluation. The diagnosis of macroadenomas is usually straightforward and these large tumors may be associated with mass effects such as severe headache, nerve palsies or visual changes. Microadenomas may be more subtle in presentation, and the diagnosis of hyperprolactinemia without radiologic evidence of a tumor frequently is problematic. The management of prolactin-secreting adenoma remains controversial, with no clear consensus or indication for surgical versus medical treatment. Surgical intervention is a realistic option for those patients who have access to an experienced neurosurgeon and who have tumor characteristics that offer a reasonable hope for cure. Many questions remain to be answered, including the cause, natural history of development and the optimum treatment for individual cases.
分泌催乳素的垂体腺瘤是妇科问题的常见原因，这些问题包括月经过少、不孕、闭经和溢乳。诊断需要结合内分泌检测和放射学评估。大腺瘤的诊断通常较为直接，这些大肿瘤可能伴有诸如严重头痛、神经麻痹或视力改变等占位效应。微腺瘤的表现可能更为隐匿，在没有肿瘤放射学证据的情况下诊断高催乳素血症常常存在问题。分泌催乳素腺瘤的治疗仍存在争议，对于手术治疗还是药物治疗尚无明确的共识或指征。对于那些能够找到经验丰富的神经外科医生且肿瘤特征有望治愈的患者，手术干预是一种现实的选择。许多问题仍有待解答，包括病因、自然发展过程以及个别病例的最佳治疗方法。
