内科学教学课件：Pituitary Tumors.pptVIP

沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 Pituitary Tumors Definition Pituitary tumors are benign monoclonal tumors that arise from one of the anterior pituitary cell types and may cause clinical effects from either over production of pituitary hormone or compressive effects on surrounding structures , including the hyperthalamus ,pituitary ,or both . Classification Initial hormonal evaluation PRL, GH , ACTH , TSH , Gn, etal. microademonas (10 mm ) macroadinomas (≥10mm) Symptoms Mass effects Headache （sella压迫鞍膈） Visual loss or bitemporal hemianopsia(颞侧偏盲） through compression of the optic chiasm. Cavernous sinus（海绵窦）:diplopia（复视） , ptosis（眼睑下垂） , ophthalmoplegia（眼外肌麻痹） , and decreased facial sensation from cranial nerve（颅神经） compression laterally . Hyperthalamus：diabetes insipidus(尿崩症）etal. Hormone Clinical manifestation GH acromegalia、giantism PRL ? femal：amenorrhea-galactorrhea male：hypogonadism ACTH Cushing FSH/LH hypogonadism TSH hyperthyroidism Initial hormone Diagnosis Symptoms Laboratory GH , PRL , TSH , ACTH, FSH/LH . Pathology CT , MRI . Treatment Surgery Radio therapy Drugs :Bromocriptine (prolactinoma) prolactinoma Essentials of Diagnosis Women: Menstrual cycle disturbanses (oligomenorrhea, amenorrhea); galactorrhea; inferility Men: Hypogonadism; decreased libido and erectile dusfunction; infertility. Elevated serum prolactin CT san or MRI often demonstrates pituitary adenoma Treatment Bromocriptine surgery 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院 沈阳医学院附属二院院