pituitary pituitary gland is located in the recess of the sphenoid bone of the skull, called the sella turcica.The pituitary gland is the main central endocrine gland, which produces a number of hormones that regulate the function of the peripheral endocrine glands.Besides the pituitary gland stimulates the body's growth and education of breast milk.The pituitary gland secrete two parts - the front (anterior pituitary) and rear (neurohypophysis).adenohypophysis cells produce thyroid-stimulating hormone (stimulates the thyroid gland), adrenocorticotropic hormone (stimulates the adrenal glands), gonadotropic hormones (affect the sex glands in men and women), and prolactin (stimulates lactation) and growth hormone (stimulates growth).Neurohypophysis stores and secretes vasopressin in the blood (reduces the amount of urine) and oxytocin (increases the tone of the muscle fibers of the uterus).pituitary disease can manifest a decrease or increase of its hormonal activity, also may cause tumors.
main tumors in sella are macro- and microadenoma pituitary craniopharyngioma, meningioma.Pituitary adenomas constitute about 15% of all intracranial tumors.The difficulties of diagnosis are possible due to the small size of pituitary tumors.Hormonally inactive pituitary education often manifest themselves later, when the symptoms of compression of surrounding tissues.Adenomas are classified by hormonal activity and size.In the secretory activity is dominated by prolactinoma, and somatotropinomy kortikotropinomy.Sometimes hormonal activity is mixed.A quarter of all adenomas does not produce hormones.On the basis of the size and characteristics of invasive pituitary tumors are divided into 2 stages: microadenoma, macroadenoma.Microadenomas less than 10 mm in diameter, do not alter the structure of the sella turcica, and do not cause symptoms of compression of surrounding tissues.Larger tumors are called macroadenomas.
microadenoma pituitary is often a random finding.This is associated with a high prevalence in the present diagnostic imaging techniques, including computer and magnetic resonance imaging of the brain.Often this study assigns a neurologist.And sometimes the patient decides independently undergo brain imaging, for whatever reasons.X-rays of the skull is not informative with regard microadenomas pituitary.
symptoms of pituitary microadenomas depend only on its hormonal activity.Microadenoma not compresses surrounding tissue, so the visual field disturbances and headache is not usually the case.As mentioned previously, 25% of pituitary tumors have hormonal activity.Microadenomas more often are not secreted.In this case, the tumor does not cause any complaints and is not a reason for seeking medical attention.
Gormonalnoaktivnye microadenoma often are prolactinomas.These tumors are common among women.Prolactin suppresses ovulation, stimulates lactation, promotes weight gain.Usually women go to the doctor with complaints of menstrual disorders and infertility.Less often at very high levels of prolactin may be discharge from the breast (spontaneous or on pressure).If there is a prolactinoma in men, impotence and the possible discharge from the breast.Excess prolactin in the blood manifested by increased body weight in the normal mode of the day, food.
somatotropinomy produce growth hormone.Such microadenoma occur in adults and children differently.Children somatotropinomy manifested primarily excessive increase in body length.In adults, bone growth zones are closed, so an increase in body length is not possible.The excess growth hormone causes acromegaly.Clinically, the disease is manifested by an increase of the hands and feet, thick fingers, brow growth, coarsening of facial features.The voice becomes lower.Acromegaly is a secondary diabetes mellitus, hypertension, increases the risk of cancer pathology.
kortikotropinomy produce adrenocorticotropic hormone.This hormone stimulates the production of cortisol in the adrenal glands.In patients developing the disease Cushing's.The first change of the patient's appearance.The limbs become thinner due to muscle atrophy and fat redistribution, excess subcutaneous fat is deposited primarily in the abdominal area.On the front of the abdominal wall skin appear bright stretching more than 1 cm in thickness (striae).A person becomes lunoobraznym, cheeks blush is always present.In patients develop secondary diabetes mellitus and hypertension.Often there are changes in mental reactions and behavior.
reason microadenoma pituitary can be several factors.The basis of tumor formation in this area is a genetic predisposition, female gender, also have values of pituitary function overload.These overloads can include pregnancy, childbirth, abortion, breastfeeding, hormonal contraception.In addition to these factors, the cause microadenoma pituitary may become infectious process in the central nervous system, head injuries.
microadenoma Treatment depends on the pituitary hormonal activity.If education does not produce hormones, the only tactics against him should be monitored.
Prolaktinomy successfully treated conservatively.The endocrinologist appoints or cabergoline bromkreptin the long term controlled studies of monthly hormonal and regular MRI.prolactinomas often reduced in size and lose their hormonal activity for 2 years.In the absence of effect of conservative therapy, the patient is sent to the operation.Radiation therapy is rarely used.
Surgical treatment is essential for growth hormone and corticotropin.Sometimes carried radial data neoplasm therapy.There are drugs to suppress the activity of the pituitary microadenomas.Somatotropinomy diminish in size and lose activity when using synthetic somatostatin analogue (Octreotide and lanreotide).Kortikotropinomy respond to treatment hloditanom (an inhibitor of the biosynthesis of hormones in the adrenal cortex) combined with the appointment of reserpine, Parlodel, difenina, Peritol.The most common medications used to prepare for radical treatment and in the postoperative period.In case of failure of surgical treatment and radiation therapy is used only conservative treatment.
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