pituitary tumor
Introduction
Introduction to pituitary tumor Pituitary tumors are a group of tumors that occur from the anterior and posterior pituitary and residual cells of the cranial pharyngeal epithelium. Clinically significant symptoms account for about 10% of intracranial tumors. Males are slightly more than females. Pituitary tumors usually occur in young adults and often affect their growth, fertility, learning and work ability. The clinical manifestations are the abnormal secretion of hormones, the tumors surrounding the pituitary tissue, the pituitary apoplexy and other anterior pituitary dysfunction. In this group of tumors, the adenomas of the former leaves accounted for the majority, and those from the posterior lobe were rare. According to incomplete statistics, the most common PRL tumors account for 50-55%, followed by GH tumors 20-23%, ACTH tumors 5-8%, TSH tumors and LH/FSH tumors are rare. Non-functional pituitary adenomas, accounting for 20-25%. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious Complications: Diabetes insipidus Cerebrospinal fluid leakage
Cause
Cause of pituitary tumor
Hypothalamic regulation dysfunction (35%):
The hypothalamic polypeptide hormone promotes the proliferation of pituitary cells. After transplantation into the GHRH gene, it can trigger the proliferation of GH cells in rats and further develop into a true pituitary tumor.
Lack of inhibitory factors can also contribute to tumorigenesis, such as ACTH adenomas can occur in patients with primary adrenal insufficiency.
Pituitary cell self-deficiency (25%):
Pituitary adenomas are derived from a mutated cell and are accompanied by cell replication resulting from monoclonal amplification or self-mutation.
Intervention of external triggers or lack of inhibitors:
Defects in 1DA (dopamine) receptor gene expression.
2 The role of oncogenes and tumor suppressor genes: Oncogenes are actually a type of genes involved in the regulation of normal cell growth. Some oncogene products are growth factors and their receptors, while others are involved in the transmission of growth signals in cells. The process, its abnormal expression can lead to abnormal cell proliferation.
Prevention
Pituitary tumor prevention
Mostly, it is preventive and health care after surgery, as follows:
1, psychological comfort, pituitary tumor is a benign tumor in the brain, the surgical effect is good, after recovery, can participate in normal work.
2, strengthen nutrition, eat more fresh, high-protein foods, enhance physical fitness, so that the body recovers soon after the disease.
3, radiotherapy time is generally about 1 month after surgery, less public places during radiotherapy, pay attention to nutrition, regular blood test.
4, according to the doctor's advice, 1 year CT review 1 time.
Complication
Pituitary tumor complications Complications, diabetes insipidus, cerebrospinal fluid leakage
Complications may occur after surgery, such as:
(1) Diabetes insipidus.
(2) sphenoid sinusitis.
(3) Water and electrolytes are disordered.
(4) Cerebrospinal fluid leakage.
(5) The visual impairment is aggravated.
(6) meningitis.
(7) Vascular damage.
(8) Central nervous system damage.
(9) Cranial nerve palsy.
Symptom
Pituitary tumor symptoms Common symptoms Amenorrhea sympathetic compensatory hyperactivity Vision defect Abnormal high amenorrhea - galactorrhea - no... Male infertility changes visual impairment
1. Hormone secretion abnormalities:
Excessive hormone secretion group, such as excessive growth hormone caused by acromegaly; hormone secretion syndrome, when non-functional tumors increase, normal pituitary tissue is destroyed, gonadotropin secretion is reduced and amenorrhea, infertility Or impotence often occurs at the earliest and more common.
2. The tumor is compressed by the surrounding tissue of the pituitary:
Nerve fiber irritation headache, persistent headache; optic nerve, optic chiasm and optic nerve bundle compression, patients with vision loss, visual field defects and fundus changes; other compression group.
Examine
Pituitary tumor examination
1. The positive lateral slice of the cranial plain film shows that the saddle is enlarged, deformed, the saddle bottom is sunken, and there is a double bottom. The saddle back is thinned and erected backward, and the bone is often absorbed and destroyed.
2. CT pituitary density is higher than brain tissue.
3, magnetic resonance imaging (MRI): the resolution of the pituitary soft tissue is better than CT, can make up for the lack of CT.
4, gas brain and cerebral angiography.
Diagnosis
Diagnosis and diagnosis of pituitary tumor
1, clinical manifestations
The patient's age, gender, symptoms of discomfort after illness, changes in the body.
2, endocrine examination
Since most pituitary tumors have a function of secreting hormones, the clinical manifestations are not obvious, and the pituitary hormones have changed when imaging has not been able to suggest tumors. Some cases of pituitary tumors can be diagnosed by endocrine testing alone.
3, imaging
(1) Skull X-ray film: This is a relatively primitive diagnostic method, based on changes in the quality of the saddle bone, calcification of the saddle area to determine the presence or absence of tumors and differential diagnosis.
(2) CT scan: only has a diagnostic value for large pituitary tumors, and small pituitary tumors are easily missed. Can not be used as the main tool for the diagnosis of pituitary tumors.
(3) MRI examination: It is the most important tool for diagnosing pituitary tumors. It can clearly show the size, shape, location of the tumor and its relationship with the surrounding structure. Even tumors with a diameter of 2 to 3 mm can be displayed. However, some tumors have similar signals to the surrounding normal pituitary tissues. The two are difficult to distinguish, and they need to be diagnosed in combination with clinical manifestations and endocrine examinations.
4, pathological examination
This is the most reliable diagnostic method and the rate of misdiagnosis is very low. Pathological diagnosis was performed by ordinary section HE staining light microscopy, which can only be used as a general diagnosis and cannot distinguish the type of tumor. Immunohistochemical staining is based on the diagnosis of hormones contained in tumor cells, and the sensitivity is high, but the rate of misdiagnosis is also high. Observed by electron microscopy, the tumor type is distinguished according to the different characteristics of the tumor cells, and it is rarely used clinically.
