Treatment of pituitary microadenomas

Pituitary microadenoma is a tumor disease that is not easy to treat. Patients with pituitary microadenoma usually have symptoms such as enlarged limbs and headaches. Pituitary microadenoma can also cause the patient's pituitary gland to be compressed by the tumor, and in severe cases it can even affect the normal function of the human brain. To treat pituitary microadenoma, the treatment method must be set according to the condition. So, how should pituitary microadenomas be treated?

1. Causes

The cause of the disease is unclear, and possible factors include: genetic factors, physical and chemical factors, and biological factors.

2. Clinical manifestations

It is related to the patient's gender, age, tumor size and extension direction, and the type of hormone secretion, and includes the following 4 groups of symptoms:

1. Symptoms and signs caused by excessive hormone secretion from pituitary tumors, the most common of which are acromegaly, Cushing's syndrome and prolactinoma.

2. The pituitary gland itself is under pressure, mainly due to the decrease in the secretion of pituitary trophic hormones. Generally, growth hormone GH is affected first, followed by luteinizing hormone, follicle-stimulating hormone, and finally adrenocorticotropic hormone and thyrotropin. A few may be accompanied by diabetes insipidus.

3. Symptoms of compression of peri-pituitary tissues, including headache, decreased vision, visual field loss, hypothalamic syndrome and cerebrospinal fluid rhinorrhea.

4. Pituitary stroke refers to infarction, necrosis or hemorrhage of pituitary adenoma and/or pituitary gland itself. Clinically, compression symptoms and meningeal irritation symptoms may appear rapidly, the clinical manifestations of hyperpituitarism may disappear or be alleviated, and even anterior pituitary function may be reduced.

Treatment

1. Surgery

It mainly includes craniotomy and transsphenoidal surgery.

2. Radiation therapy

It has a certain effect on pituitary adenomas. It can control the development of tumors, sometimes shrink tumors, and improve visual field, but it cannot cure them fundamentally.

3. Medication

Bromocriptine is a semisynthetic ergotamine bioalkaloid that can stimulate the dopamine receptors of pituitary cells to reduce the effect of prolactin in the blood. Taking bromocriptine can shrink prolactinoma, restore menstruation and ovulation and pregnancy, and inhibit galactorrhea. However, bromocriptine cannot fundamentally cure prolactinoma. After stopping the drug, the tumor may continue to grow and the symptoms will reappear. In addition, bromocriptine can also relieve symptoms of growth hormone cell adenoma, but the dosage is large and the efficacy is poor.

Prevent infection, treat symptoms, and deal with complications accordingly if any. The main drugs for correcting cerebral edema and reducing intracranial pressure are 20% mannitol, furosemide, and dexamethasone, and even human albumin can be used. Pay attention to electrolyte and fluid balance, and replenish blood loss during surgery.