Hyperpituitary syndromes

Pituitary tumors

病生理:
 
   Adenoma:
      -分泌過多trophic hormone (但30-40%沒功能)
      -可能潛藏defi in other trophic hormones (due to compression)
      -若是prolactinoma, 有10%會另外分泌 PRL & GH.

臨床表現:

  syndrome due to hormone oversecretion +/-
  mass effect: 頭痛, visual change, 複視, cranial neuropathies

Workup:
  MRI, hormone levels, +/- visual field testing, consider MEN 1
  -if < 10 mm, no mass effect, no hormonal effects, f/u q 3-6m


-------------------------------------------------------------------------

Hyperprolactinemia (NEJM 2010;362:1219)

Etiology:
 
   Prolactinoma (占50% pituitary adenomas)
   non-prolactinoma with stalk 擠壓 (-> 減少inhibitory dopamine ->增加 PRL (mild))