Recent Developments in the Management of Hormone-Secreting Pituitary Tumors

摘要

This review summarizes the status of pituitary secretory tumors, and highlights recent advances in their diagnosis and management. Prolactinomas occur most commonly. Surgery produces a high cure rate, but one must consider the significance of recurrence of hyperprolactinemia years after surgery. Medical therapy, radiotherapy, and close observation alone also are acceptable. Women with these tumors fare well during pregnancy. With careful selection, the end result is favorable in the majority of patients. Acromegaly demands definitive therapy. Radiotherapy produces results equal to surgery, although more slowly. Effective pharmacologic therapy is not widely available, but may be on the horizon. Cushing's disease continues to be devastating to patients. Neurosurgeons have had the greatest recent impact on this disorder, but they must be aware of the special characteristics of this small, intraglandular tumor. Thyrotropin-secreting tumors are uncommon. Nevertheless, they are being described with increasing frequency. Finally, gonadotropin-secreting tumors are the most recent ones to be described, one principally to their lack of specific hormonal symptoms.