Aron D C, Tyrrell J B, Wilson C B
Division of Clinical and Molecular Endocrinology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
West J Med. 1995 Apr;162(4):340-52.
Diagnostic advances have resulted in earlier and more frequent recognition of pituitary tumors. Pituitary tumors cause problems owing to the hormones they secrete or the effects of an expanding sellar mass--hypopituitarism, visual field abnormalities, and neurologic deficits. Prolactin-secreting tumors (prolactinomas), which cause amenorrhea, galactorrhea, and hypogonadism, constitute the most common type of primary pituitary tumors, followed by growth hormone-secreting tumors, which cause acromegaly, and corticotropin-secreting tumors, which cause Cushing's syndrome. Hypersecretion of thyroid-stimulating hormone, the gonadotrophins, or alpha-subunits is unusual. Nonfunctional tumors currently represent only 10% of all clinically diagnosed pituitary adenomas, and some of these are alpha-subunit-secreting adenomas. Insights into the pathogenesis and biologic behavior of these usually benign tumors have been gained from genetic studies. We review some of the recent advances and salient features of the diagnosis and management of pituitary tumors, including biochemical and radiologic diagnosis, transsphenoidal surgery, radiation therapy, and medical therapy. Each type of lesion requires a comprehensive but individualized treatment approach, and regardless of the mode of therapy, careful follow-up is essential.
诊断技术的进步使得垂体肿瘤能够被更早且更频繁地识别出来。垂体肿瘤因其分泌的激素或蝶鞍区肿块增大产生的影响而引发问题，如垂体功能减退、视野异常和神经功能缺损。分泌催乳素的肿瘤（催乳素瘤）会导致闭经、溢乳和性腺功能减退，是最常见的原发性垂体肿瘤类型，其次是分泌生长激素的肿瘤，可导致肢端肥大症，以及分泌促肾上腺皮质激素的肿瘤，会引发库欣综合征。促甲状腺激素、促性腺激素或α亚基分泌过多的情况较为罕见。目前，无功能肿瘤仅占所有临床诊断垂体腺瘤的10%，其中一些是分泌α亚基的腺瘤。通过遗传学研究，人们对这些通常为良性肿瘤的发病机制和生物学行为有了深入了解。我们回顾垂体肿瘤诊断和治疗的一些最新进展及显著特点，包括生化和放射学诊断、经蝶窦手术、放射治疗和药物治疗。每种类型的病变都需要综合但个体化的治疗方法，并且无论采用何种治疗方式，密切随访都是必不可少的。
