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1、PituitaryAdenomas(Macroadenomas)浙醫(yī)二院內分泌科任躍忠20101211PituitaryMacroadenomasThesellar蝶鞍regionisasiteofvarioustypesoftumors.Pituitaryadenomasarethemostcommonandaccountfor10-15%ofallintracranialtumors.Tumorsexceeding10mmaredefinedasmacroadenomas,andthosesmallerthan10mmaretermedmicroadenomas.Mo
2、stpituitaryadenomasaremicroadenomas.PathophysiologyPituitarymacroadenomasarebenignepithelialneoplasmscomposedofadenohypophysialcells.Primarymalignanttumorsofthepituitaryareextremelyrare..Pituitarytumordevelopmentisamonoclonalprocesswithseveralcontributingfactors.…arisefromamutatedpituitar
3、ycell.…remainunknown.Somepituitarytumorsmayoccuraspartofaclinicalsyndrome.In?multipleendocrineneoplasiatype1(MEN1).FrequencyUnitedStatesPituitarytumorsarefoundonautopsyinasmanyas25%ofunselectedcases.Theannualincidenceofpituitaryneoplasmsvariesfrom1-7casesper100,000populationbasedonneurosu
4、rgicalseries.Mortality/MorbidityMorbidityinpituitarymacroadenomasvariesfromincidentallydiscoverednonfunctioningtumorstodisablingmacroadenomas.Morbidityresultsfrommasseffects(eg,bitemporalhemianopsia雙顳側偏盲),hormonalimbalance(pituitaryhormonedeficiencyduetocompressionofthenormalpituicytesorh
5、ormonalexcessfromthetumor),andpatientcomorbidities.Significantmorbidityisalsoassociatedwithtreatmentofthesetumors.RaceNoracialpredilectionexistsforpituitarymacroadenomas.SexAutopsyseriesshowanequaldistributionofpituitarytumorsbetweenmenandwomen.Corticotropinomas..mainlyinwomen,..4:1...Ame
6、norrhea(ormenstrualirregularities),whichisarelativelycommonsymptominwomenwithmacroadenomas,raisesthesuspicionofapituitarylesion.AgeTumorsaffectindividualsofallages,butincidenceincreaseswithage,peakingbetweenthethirdandsixthdecadesoflife.ClinicalHistoryPatientswithpituitarymacroadenomasmay
7、beasymptomaticormaypresentwithcomplaintsduetohormonalimbalanceormasseffects.Pituitaryhormoneeffectsdependonthehormonesinvolved.Panhypopituitarism…spared.Thelargerthetumor,themorelikelyitistoinvolvemosthormones...Themostsensitivearethesomatotrophsandthegonadotrophs,w
