UPDATED TREATMENT STRATEGY FOR PITUITARY ADENOMAS

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  • 脳下垂体腫瘍に対する治療戦略のアップデート

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We summarize here the current treatment strategy for pituitary adenomas. Pituitary adenomas generally could be divided into two groups; one is functioning adenoma, and the other is non-functioning adenoma. Functioning adenomas include acromegaly, prolactinoma, Cushing disease, and TSH secreting adenoma.<br>Transsphenoidal surgery is the first-line therapy for acromegaly, and both medical therapy and radiotherapy are also available and effective for noncurative tumors after surgery.<br>Prolactinomas are well controlled using dopamine agonists, and some noninvasive microadenomas could be treated by surgery alone.<br>Transshenoidal surgery seems to be curative therapy for most of Cushing diseases, and radiosurgery is expected to control the tumor remnant after surgery. We don't have any effective medical therapy for Cushing disease at the present moment, so inhibitory drugs for adrenal enzymes should be used in order to control hypercortisolemia.<br>TSH secreting adenoma is a rare tumor developed with hyperthyroidism, and the syndrome of inappropriate secretion of TSH (SITSH) has diagnostic value for TSH secreting adenoma.<br>Though Non-functioning adenomas generally tend to be diagnosed with visual impairment, some asymptomatic tumors are incidentally discovered by the result of brain checking, so called as pituitary incidentalomas.<br>Endoscopic surgical procedures have been widely used during transsphenoidal surgery, which contribute to radical resection of tumors.

Journal

  • JIBI INKOKA TEMBO

    JIBI INKOKA TEMBO 53 (3), 191-198, 2010

    Society of Oto-rhino-laryngology Tokyo

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