南方医科大学：《内科学》课程教学课件（讲稿）第七篇 内分泌和代谢性疾病 第三章 垂体病 Pituitary Tumour

Pituitary Tumour 垂体瘤 General Information概述 Cerebral cortex Pituitary adenomas are typically benign, slow-growing tumors oPituitary adenomas are approximately 15%of primary brain tumors. Pituitary adenomas can invade adjacent structures(cavernous sinus:海绵窦) oPituitary adenomas have separate Optic names based on their size nerve A microadenoma微腺擅1cm Tumor Hypothalamus

lPituitary adenomas are typically benign, slow-growing tumors lPituitary adenomas are approximately 15% of primary brain tumors. lPituitary adenomas can invade adjacent structures ( ) lPituitary adenomas have separate names based on their size ： 1 cm

side-view MRI Microadenoma (4mm)】 Microadenoma: cushing disease Patient 1 Macroadenoma (25mm) Macropituitary adenoma: patient 2

Microadenoma： Macropituitary adenoma：

Giant macroadenoma side-view MRI (5cm) Macropituitary adenoma: patient 3 Most pituitary adenomas occur spontaneously,not inherited. Cases of familial pituitary tumorsare rare. Multiple Endocrine Neoplasia type 1(MEN 1)is a rare condition characterized by simultaneous tumors of the pituitary,pancreas and parathyroid glands.多发性内分泌腺病1型

Macropituitary adenoma： nMost pituitary adenomas occur spontaneously, not inherited. nCases of familial pituitary tumorsare rare. nMultiple Endocrine Neoplasia type 1 (MEN 1) is a rare condition characterized by simultaneous tumors of the pituitary, pancreas and parathyroid glands

Fig Large pituitary tumour 图： 巨大的垂体瘤

Fig: Large pituitary tumour 图： 巨大的垂体瘤

Fig: Large pituitary craniopharyngioma duct tumor 图： 巨大的垂体颅咽管瘤

Fig: Large pituitary craniopharyngioma duct tumor 图： 巨大的垂体颅咽管瘤

Symptoms Caused by Pituitary Adenomas Pituitary adenomas are generally thought of as either hormone- producing or hormone-inactive tumors 1.Hormone-producing pituitary adenomas produce an active hormone in excessive amounts 2.Hormone-inactive(non-functional)pituitary adenomas typically cause problems related to the size of the tumor

Symptoms Caused by Pituitary Adenomas uPituitary adenomas are generally thought of as either or hormone-inactive tumors produce an active hormone in excessive amounts. typically cause problems related to the size of the tumor

Symptoms Caused by Pituitary Adenomas ◆Hormone-producing pituitary adenomas激素分泌型垂体腺瘤 The three most common hormone-producing adenomas are: 1.Prolactinoma泌乳素瘤：causes loss of menstrual periods and breast milk production in women. 2.Growth hormone-secreting pituitary adenoma生长激素瘤： excessive growth hormone(GH)production causes acromegaly in adults or gigantism in children. 3.ACTH-secreting pituitary adenoma:excessive ACTH hormone produced by the pituitary gland causes Cushing's disease库欣氏 4.Other tumors are very rare TSH producing Adenoma

Symptoms Caused by Pituitary Adenomas uHormone-producing pituitary adenomas The three most common hormone-producing adenomas are: causes loss of menstrual periods and breast milk production in women. excessive (GH) production causes acromegaly in adults or gigantism in children. excessive hormone produced by the pituitary gland causes

Non-lactating Engorged Prolactinoma prolactin Milk glands- ADAM. 溢乳 Galactorrhea milk

Prolactinoma

gthe height of giantism kid and adult巨人症患者

Fig：the height of giantism kid and adult巨人症患者

Fig:MRI of gangtic GH pituitary tumour Fig:contrast of two hands 图：巨大的生长激素瘤MRI 图：手掌对比（和正常人比较）

Fig: MRI of gangtic GH pituitary tumour 图：巨大的生长激素瘤MRI Fig: contrast of two hands 图：手掌对比（和正常人比较）