下垂体腺腫の診断と管理: レビュー
Nicholas A Tritos1,2, Karen K Miller1,2
1Neuroendocrine Unit, Massachusetts General Hospital, Boston.
JAMA
|April 25, 2023
まとめ
下垂体腺腫は下垂体腺の腫瘍で 1100人に1人が罹患しています 治療は様々です 殆どの場合は手術ですが プロラクチノーマは薬で治療します
科学分野:
- 内分泌学と腫瘍学:下垂体腺腫,その分類,および臨床的症状に焦点を当てています.
背景:
- 下垂体腺腫は下垂体細胞から発症する腫瘍で,約1100人に1人に発症する.
- これらの腫瘍は,機能する (ホルモン分泌) または機能しない,および大きさによってマクロアデノーマ (≥10mm) とマイクロアデノーマ (<10mm) に分類されます.
研究 の 目的:
- 下垂体腺腫の分類,臨床表現,治療について検討する.
- 影響を受けた患者の内分泌と眼科の評価の重要性を強調する.
- 腫瘍の種類と特徴に基づいて現在の第一線治療戦略を概説する.
主な方法:
- サイズ (マイクロアデノマ vs マクロアデノマ) と機能 (機能性 vs 非機能性) に基づいて下垂体腺腫の分類.
- ホルモンの過分分泌症候群と質量効果症状を含む臨床症状のレビュー
- 内分泌の評価と視野検査を含む診断評価の要約
- 治療方法の概要 医学的介入と外科的介入の区別
主要な成果:
- 機能する腫瘍には,プロラクティノーマ (53%),ソマトトロピノーマ (12%) およびコルチコトロピノーマ (4%) が含まれる.
- マクロアデノマは視野の欠陥 (18-78%),頭痛 (17-75%),下垂体症 (34-89%) を引き起こす可能性があります.
- 非機能性腺腫は pituitary 腫瘍の30%を占める.
結論:
- プロラクチノーマの第一線治療は,医療療法 (ブロモクリプチンまたはカベルゴリン) です.
- トランスフェノイド性下垂体手術は,他の介入を必要とする下垂体腺腫の主要な治療法です.
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