Prolactinoma

ʻO kahi prolactinoma kahi tumo pituitary noncancerous (benign) e hana i kahi hormone i kapa ʻia ʻo prolactin. ʻO kēia ka hopena i ka nui o ka prolactin i ke koko.

ʻO Prolactin kahi hormone e hoʻonāukiuki i nā umauma e hana i ka waiū (lactation).

ʻO Prolactinoma ka ʻano maʻamau o ka pituitary tum (adenoma) e hana ana i kahi hōmona. Hana ʻia ma kahi o 30% o nā adenomas pituitary a pau. ʻO ka ʻaneʻane kokoke i nā pituitary tumors he noncancerous (benign). Kū paha ʻo Prolactinoma ma ke ʻano he ʻāpana o ke ʻano hoʻoilina i kapa ʻia he endopine neoplasia ʻano 1 (MEN 1).

Kū pinepine ʻo Prolactinomas i ka poʻe ma lalo o 40 mau makahiki. ʻOi aku ka maʻamau o lākou i nā wahine ma mua o nā kāne, akā kākaʻikahi ka poʻe kamaliʻi.

ʻO ka liʻiliʻi ma ka liʻiliʻi o ka hapa nui o nā prolactinomas āpau (ʻoi aku ma mua o 1 kenimika a i ʻole 3/8 o kahi iniha ke anawaena). Kū pinepine kēia mau tumors liʻiliʻi i nā wahine a kapa ʻia he microprolactinomas.

ʻO nā tumors ʻoi aku ka nui ma mua o nā kāne. Kū lākou i kahi makahiki ʻelemakule. Hiki ke ulu ka tumo i kahi nui ma mua o ka ʻike ʻia o nā ʻōuli. ʻO nā tumors i ʻoi aku ma mua o 3/8 ʻīniha (1 cm) i ke anawaena i kapa ʻia he macroprolactinomas.

ʻIke pinepine ʻia ka tumo i ka wā ma mua o nā wahine ma mua o nā kāne ma muli o nā wā menstrual maʻamau.

I nā wahine:

• Kahe ka waiū kūpono ʻole mai ka umauma i kahi wahine hāpai ʻole a hānai (galactorrhea)
• Palupalu umauma
• Hoemi i ka hoihoi wahine
• Hoemi i ka hihio ākea
• ʻEha poʻo
• Hoʻoipo
• ʻO ka kū ʻana o ka menstruation ʻaʻole pili i ka menopause, a i ʻole menstruation maʻamau
• Hoʻololi ka hihiʻo

I nā kāne:

• Hoemi i ka hoihoi wahine
• Hoemi i ka hihio ākea
• Ka hoʻonui ʻana i kaʻiʻo o ka umauma (gynecomastia)
• ʻEha poʻo
• Nā pilikia kūkulu hale (impotence)
• Hoʻoipo
• Hoʻololi ka hihiʻo

ʻO nā ʻōuli i hoʻokumu ʻia e ke kaomi mai kahi tumo nui aʻe e komo pū paha:

• ʻEha poʻo
• Lethargy
• Kahe wai nasal
• ʻO Nusea a me ka luaʻi
• Nā pilikia me ke ʻano o ka pilau
• ʻEha Sinus a i ʻole kaomi
• Hoʻololi ka hihiʻo, e like me ka hihiʻo lua, nā lihilihi eyelids a i ʻole ka nalo ʻana o ke kahua ʻike

ʻAʻohe paha hōʻailona, ​​keu hoʻi i nā kāne.

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona. E nīnau ʻia ʻoe e pili ana i nā lāʻau a me nā lāʻau āu e lawe nei.

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• ʻO Pituitary MRI a i ʻole scan CT lolo
• Pae testosterone ma nā kāne
• Pae Prolactin
• Nā hoʻāʻo ʻana o ka hana thyroid
• Nā ho'āʻo ʻē aʻe o ka hana pituitary

Kūleʻa ka lāʻau i ka mālama ʻana i ka prolactinoma. Pono kekahi poʻe e lawe i kēia mau lāʻau no ke ola. Hiki i nā kānaka ʻē aʻe ke hōʻoki i ka lawe ʻana i nā lāʻau i hope o kekahi mau makahiki, keu hoʻi inā liʻiliʻi kā lākou tumo i ka wā i loaʻa ai a ua nalo paha mai ka MRI. Akā aia kahi makaʻu e ulu paha ka tumo a hana hou i ka prolactin, keu hoʻi inā he tumo nui ia.

Hiki i kahi prolactinoma nui nui ke hoʻonui i kekahi manawa i ka wā hāpai.

Hana ʻia ke kaha no kekahi o kēia mau mea:

• Kūleʻa nā ʻōuli, e like me ka hōʻeha ʻana o ka ʻike
• ʻAʻole hiki iā ʻoe ke hoʻomanawanui i nā lāʻau e mālama ai i ka tumo
• ʻAʻole pane ka tumo i nā lāʻau

Hoʻohana wale ʻia ka uila i nā poʻe me ka prolactinoma e hoʻomau nei e ulu a i ʻole maikaʻi aʻe ma hope o ka hoʻāʻo ʻana o ka lāʻau. Hāʻawi ʻia ka kukuna i ke ʻano o:

• Pāhawewe kuʻuna
• Pahi Gamma (stereotactic radiosurgery) - kahi ʻano o radiation radiation e kia ana i nā kukuna x kiʻekiʻe i kahi wahi liʻiliʻi i ka lolo.

Maikaʻi loa ka kuanaʻike, akā pili i ka kūleʻa o ka lāʻau lapaʻau a i ʻole ke ʻoki kino. Ke hoʻāʻo ʻana e nānā inā hoʻi ka huelo i hoʻi mai ma hope o ka mālama ʻana he mea nui.

Hiki i ka mālama ʻana no ka prolactinoma ke hoʻololi i nā pae o nā hormones ʻē aʻe i ke kino, keu hoʻi inā e hana ʻia ke ʻoki a me ka radiation.

Hiki ke pili i nā pae kiʻekiʻe o ka estrogen a testosterone paha i ka ulu ʻana o kahi prolactinoma. Pono e ukali pono ʻia nā wahine me nā prolactinomas i ka wā hāpai. Pono lākou e kūkākūkā i kēia tumo me kā lākou mea hāʻawi ma mua o ka lawe ʻana i nā lāʻau kaohi hānau me kahi kiʻekiʻe ma mua o ka ʻike estrogen.

E ʻike i kāu mea hāʻawi inā loaʻa iā ʻoe nā hōʻailona o ka prolactinoma.

Inā loaʻa iā ʻoe kahi prolactinoma i ka wā ma mua, e kāhea i kāu mea hoʻolako no kahi ukali maʻamau, a inā hoʻi e hoʻi kāu mau ʻōuli.

Adenoma - hūnā; Prolactin - hūnā i ka adenoma o ka pituitary

• Nānā Endocrine

ʻO Bronstein MD. Nā maʻi o ka huna prolactin a me nā prolactinomas. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 7.

Tirosh A, Shimon I. Ke kū nei i kēia manawa i nā mālama ʻana no nā prolactinomas. ʻO Minerva Endocrinol. 2016; 41 (3): 316-323. PMID: 26399371 www.ncbi.nlm.nih.gov/pubmed/26399371.