内分泌
词汇介绍
拓展阅读
解析
Pituitary 英 /pɪˈtjuːɪtəri/ 美 /pɪˈtuːəteri/
释 义 n. （脑）垂体
adj. 脑垂体的；脑垂体分泌失调引起的
例 句 Your pituitary gland pumps this stuff out a part of the stress response. 你的脑垂体释放这种物质作为对压力反应的一部分。
Tumor 英 /'tju:mə(r)/ 美 /'tjʊmɚ/
释 义 n. 肿瘤；肿块；赘生物
例 句 So antiangiogenesis will be an efficient method in the inhibition of the growth and metastasis of tumor. 所以抗血管生成将是一种很有希望的对抑制肿瘤生长和转移的有效方法。
概述
概述
垂体瘤是在垂体中异常生长的肿瘤，某些垂体肿瘤会导致过多的激素调节人体的重要功能，一些垂体瘤可导致垂体产生较低水平的激素。大多数垂体肿瘤是非癌性（良性）生长。腺瘤残留在垂体或周围组织中，不会扩散到身体的其他部位。
与肿瘤压力有关的体征和症状
相关症状可能包括：头痛；视力丧失，特别是周围视力丧失。
与激素水平变化有关的症状
垂体功能正常的肿瘤会导致激素过度产生。垂体中不同类型的功能性肿瘤会引起特定的体征和症状，有时甚至压迫症状与功能失调症状均出现。
大肿瘤可能会导致荷尔蒙缺乏，体征和症状包括：恶心和呕吐；感觉冷；月经稀发或闭经；性功能障碍；尿量增加；异常的体重减轻或增加。
促肾上腺皮质激素分泌（ACTH）肿瘤
ACTH肿瘤产生激素促肾上腺皮质激素，刺激肾上腺产生激素皮质醇。库欣综合症是由肾上腺产生过多的皮质醇引起的。库欣综合症的可能症状和体征包括：上腹部和上背部周围的脂肪堆积；满月脸；手臂和腿部变薄伴有肌肉无力；高血压；高血糖；粉刺；瘀血；妊娠纹；焦虑，烦躁或沮丧。
生长激素分泌型肿瘤
这些肿瘤会产生过量的生长激素（肢端肥大症），可能导致：面部特征粗大；手脚增大；出汗过多；高血糖；心脏问题；关节痛；毛发旺盛；
儿童和青少年生长发育过快。
催乳素分泌肿瘤
垂体瘤（催乳素瘤）分泌的催乳素过多会导致正常的性激素（女性中的雌激素和男性中的睾丸激素）水平降低。血液中过多的催乳素对男人和女人的影响不同。
在女性中，催乳素瘤可能引起：月经不调、经期不规律、乳汁异常分泌。在男性中，产生催乳激素的肿瘤可能导致男性性腺功能减退。体征和症状可能包括：勃起功能障碍、精子数量减少、性欲丧失、乳房发育。
促甲状腺激素分泌肿瘤
当垂体肿瘤过度产生刺激甲状腺的激素时，甲状腺会分泌过多的甲状腺素。这是甲亢或甲状腺机能亢进的罕见原因。甲状腺功能亢进会加速人体的新陈代谢，从而引起体重减轻、快速或不规则心跳、紧张或烦躁、排便频繁、出汗过多。
诊断
血液和尿液检查：这些测试可以确定体内激素水平是否正常。
脑成像：大脑的CT扫描或MRI扫描可以判断垂体瘤的位置和大小。
视觉测试：这可以确定垂体肿瘤是否损害了视力或周围视力。
治疗
许多垂体瘤不需要治疗。对于那些确诊的患者，治疗方法取决于肿瘤的类型、大小以及它进入大脑的距离。患者的年龄和整体健康状况也是考虑因素。
治疗需要多名医疗专家的配合，其中可能包括脑外科医师、内分泌系统专家和放射肿瘤学家。医生通常单独或联合使用外科手术，放射疗法和药物来治疗垂体瘤并使激素产生进而恢复正常水平。
复制标题经蝶垂体瘤术后医源性颅内颈内动脉假性动脉瘤的管道栓塞治疗: 病例报告及文献复习
发表时间：2019-09-10
影响指数：1.5
作者： Yasuhiko Nariai
期刊：Interv Neuroradiol
This case indicates the prospective possibility of using flow-diverting stents for the treatment of pseudoaneurysms, especially for those caused following TSS. Flow-diverting stents can enable us to treat the pseudoaneurysms with preservation of the parent artery in a less invasive manner. In TSS, life-threatening complications such as hemorrhage from ICA injuries can arise. The cavernous segments of the ICA are at risk during surgical exploration of the pituitary gland such as when removing the sellar floor, opening the sellar dura, and resecting tumors. The reported incidence of ICA injuries during TSS for pituitary tumors ranges between 0.55 and 1.1%. ICA pseudoaneurysms resulting from iatrogenic injuries during TSS are similar to blood blister-type aneurysms histologically (indicating focal artery laceration), and geographically (occurring at non-branching sites of the ICA), with the possibility for rapid enlargement and rupture with a 30–50% reported mortality rate. Although shrinkage and spontaneous resolution of intracranial pseudoaneurysms have been reported, clinical series have reported rupture rates of up to 60% prior to definitive treatment. In a review by Alzhrani et al., the time of diagnosis of pseudoaneurysms after TSS injuries ranges from 2 days to 10 years postoperatively. Patients with ICA pseudoaneurysms present with cranial neuropathy, carotid-cavernous fistula (CCF), pituitary apoplexy, or epistaxis. Prompt angiography after initial management of acute bleeding with nasal packing allows assessment of whether there is ongoing hemorrhage and can be used to identify the presence of pseudoaneurysms or CCF. Among Michael et al.’s cohort, 23% of patients with cavernous carotid pseudoaneurysm after TSS did not show evidence of vascular injury or hemorrhage during the operation, implying likely subtle carotid injuries that were unrecognized during the surgery. Patients with a history of TSS should be immediately inspected for iatrogenic vascular abnormalities once they present with epistaxis, visual impairment, external ophthalmoplegia, or bruit, even if there is no evidence of injury in the ICA.
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