What is a pituitary adenoma?
Pituitary adenomas are tumors formed by anterior pituitary cells and are mostly benign. It has been shown that the incidence of pituitary adenoma has increased from 1 in 100,000 to 7 to 10 in 100,000. In other words, there are seven to ten pituitary tumors in every 100,000 people each year.
What are the symptoms of pituitary tumors?
A: To answer this question, we must first know the classification of pituitary tumors, which can be classified according to the type of hormone secreted: 1) Prolactin-type (PRL-type) pituitary tumors: men show a decreased libido, women show irregular menstruation or even amenorrhea, infertility, and overflow of milk (milk).
2) Growth hormone type (GH) pituitary tumor: Those with prepubertal onset show gigantism, and adults may have facial changes, enlarged hands and feet, dark skin, and elevated blood sugar. Typical appearance changes: face, hands and feet.
3) ACTH type pituitary tumor: The main manifestations are obesity, full-moon face, buffalo back, hypertension, hairiness, and purple skin lines on the thighs and abdomen (purple skin lines on the body). Typical cosmetic changes: face.
4) Non-functional adenoma: It does not secrete hormones and its clinical manifestations are not obvious, so it is often not easy to be detected in the early stage. If the tumor grows and compresses the surrounding tissue structures, headache, vision loss and narrowing of visual field may occur. Other tumors such as compression of the dura mater around pituitary gland may cause headache; compression of the optic nerve crosses may cause visual acuity and visual field impairment; compression of the cavernous sinus may cause eye movement disorder; tumor developing posteriorly and superiorly may cause uveitis and hypothalamic dysfunction.
5) Other types thou FSH, LH, TSH type pituitary tumors are rare. In addition to their respective symptoms, common manifestations include polyhydramnios (thirst and urination), headache, dizziness, significant loss of vision, and visual field defects (difficulty seeing on both sides). In the case of pituitary tumor stroke (tumor bleeding) there can also be severe headache, nausea, vomiting, and even blindness.
How is pituitary tumor diagnosed?
After clinical symptoms appear, the diagnosis is mainly based on CT, magnetic resonance imaging (MRI) and endocrine hormone examination, which can initially clarify the presence of pituitary tumor, the size of the tumor, and the invasion of surrounding blood vessels and nerves. Endocrine hormone examination can clarify which pathological type of tumor belongs to.
What are the treatment methods of pituitary tumor?
1.Surgical treatment advantage: “immediate effect”. The percentage of resection and remaining should be roughly known immediately after surgery. The main complications of surgery are postoperative intersaddle hematoma, epistaxis (bleeding from ruptured pseudoaneurysm), cerebrospinal fluid nasal leakage, meningitis, hypopituitarism, uveitis (most of them are transient), water-electrolyte disorder, ophthalmic muscle paralysis, nasal diaphragm perforation, etc. The mortality rate of transcranial pituitary adenoma surgery in the early 20th century was reported to be over 10%. With the development of science and technology, advancement of treatment technology and accumulation of surgical experience, the mortality rate of surgery has decreased to 1%-2%. and postoperative cardiovascular accidents. The postoperative residual part can be treated with gamma knife.
2, and gamma knife belongs to the micro-invasive treatment, “embellishment”. Only need to fix the positioning frame on the skull can be treated, outpatient treatment is completed on the same day, and the whole treatment process patients are always awake, basically avoiding the risk of anesthesia and bleeding. Possible complications include: edema causing headache, dizziness, nausea and vomiting in some patients; unexpected attacks of pre-existing cardiovascular, cerebrovascular disease and diabetes, so patients should maintain their original normal treatment as prescribed by the doctor. Skin local infection, after treatment should avoid localization point contact with dirty water and other dirt. 1970s Backlund first applied gamma knife to treat pituitary tumors successfully, so far the world has applied gamma knife to treat pituitary tumors more than 10,000 cases, has accumulated a wealth of clinical experience, the efficiency rate of 95%-98.5%.
3, drug treatment: ① bromocriptan, a dopamine excitatory drug, can inhibit the excessive secretion of prolactin, but can not eliminate the tumor, must be taken for a long time, and can relapse after discontinuation. Side effects include dizziness, nausea, constipation and sometimes upright hypotension. It is contraindicated in people with poor heart, lung and kidney function. ②Segentin, an S-monochromotropic straw antagonist, can inhibit the release of ACTH from the hypothalamic-pituitary axis and has some inhibitory effect on adrenocorticotropic hormone adenoma. It needs to be taken for a long time and can cause relapse after stopping the drug. Common side effects include weight gain, drowsiness, etc.
What kind of pituitary tumors can be treated with Gamma Knife?
① tumor more than 2mm from the optic nerve intersection; ② no visual field impairment, or mild visual field impairment; ③ surgery residual or after surgery, radiotherapy, chemotherapy is ineffective or recurrence; ④ tumor that grows downward erosion; ⑤ patients who are old and weak, have cardiovascular, cerebrovascular, endocrine and other comorbidities, and have difficulty in tolerating surgical trauma.
Do I have to take a new film for gamma knife treatment of pituitary tumor?
Many patients have had multiple films and blood tests before treatment, but MRI must also be taken at the time of treatment. The reason is that the previous films are for diagnostic purposes and the computerized planning system during Gamma Knife treatment must determine the tumor location and calculate the coordinates of the target area with the help of the positioned MRI films. Moreover, the positioned MRI has specific requirements in terms of scan angles and parameters and must be performed on the day of treatment, after the positioning head frame is installed.
How are the results of pituitary tumors seen?
After treatment, it is important to follow the doctor’s schedule and have regular follow-up examinations, including: improvement of symptoms, recovery of hormone levels, morphological changes of the tumor (imaging examinations).