垂体瘤处理 ppt课件.ppt

Pituitary Adenomas(Macroadenomas) 浙医二院内分泌科 任跃忠 Pituitary Macroadenomas The sellar蝶鞍region is a site of various types of tumors. Pituitary adenomas are the most common and account for 10-15% of all intracranial tumors. Tumors exceeding 10 mm are defined as macroadenomas, and those smaller than 10 mm are termed microadenomas. Most pituitary adenomas are microadenomas. Pathophysiology Pituitary macroadenomas are benign epithelial neoplasms composed of adenohypophysial cells. Primary malignant tumors of the pituitary are extremely rare.. Pituitary tumor development is a monoclonal process with several contributing factors. … arise from a mutated pituitary cell. … remain unknown. Some pituitary tumors may occur as part of a clinical syndrome. In?multiple endocrine neoplasia type 1 (MEN 1). Frequency United States Pituitary tumors are found on autopsy in as many as 25% of unselected cases. The annual incidence of pituitary neoplasms varies from 1-7 cases per 100,000 population based on neurosurgical series. Mortality/Morbidity Morbidity in pituitary macroadenomas varies from incidentally discovered nonfunctioning tumors to disabling macroadenomas. Morbidity results from mass effects (eg, bitemporal hemianopsia双颞侧偏盲), hormonal imbalance (pituitary hormone deficiency due to compression of the normal pituicytes or hormonal excess from the tumor), and patient comorbidities. Significant morbidity is also associated with treatment of these tumors. Race No racial predilection exists for pituitary macroadenomas. Sex Autopsy series show an equal distribution of pituitary tumors between men and women. Corticotropinomas .. mainly in women, .. 4:1. .. Amenorrhea (or menstrual irregularities), which is a relatively common symptom in women with macroadenomas, raises the suspicion of a pituitary lesion. Age Tumors affect individuals of all ages, but incidence increases with age, peaking between the third and sixth decades of life. Clinical History Patients with pituitary