A hypophysisadenomák kezelése

Translated title of the contribution: Treatment of pituitary adenomas

E. Mezősi, Orsolya Nemes

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.

Original languageHungarian
Pages (from-to)1803-1810
Number of pages8
JournalOrvosi Hetilap
Volume150
Issue number39
DOIs
Publication statusPublished - 2009

Fingerprint

Pituitary Neoplasms
Dopamine Agonists
Somatostatin
Therapeutics
Neoplasms
Radiotherapy
Pituitary Diseases
Somatotropin Receptors
Hormone Antagonists
Prolactinoma
Pituitary ACTH Hypersecretion
Hyperprolactinemia
Acromegaly
Bromocriptine
Hungary
Radiosurgery
Neurosurgery
Pituitary Gland
Prolactin
Adenoma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A hypophysisadenomák kezelése. / Mezősi, E.; Nemes, Orsolya.

In: Orvosi Hetilap, Vol. 150, No. 39, 2009, p. 1803-1810.

Research output: Contribution to journalArticle

Mezősi, E. ; Nemes, Orsolya. / A hypophysisadenomák kezelése. In: Orvosi Hetilap. 2009 ; Vol. 150, No. 39. pp. 1803-1810.
@article{ccbba999c0d848b79862aca73c149302,
title = "A hypophysisadenom{\'a}k kezel{\'e}se",
abstract = "According to epidemiological studies, the prevalence of pituitary adenomas is 16.5{\%} and the majority of them are {"}incidentalomas{"}. The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.",
keywords = "Dopaminagonista, Dopamine agonist, Hypophysisadenoma, Pituitary adenoma, Prolactinoma, Somatostatin analog, Szomatosztatinanal{\'o}g",
author = "E. Mezősi and Orsolya Nemes",
year = "2009",
doi = "10.1556/OH.2009.28584",
language = "Hungarian",
volume = "150",
pages = "1803--1810",
journal = "Orvosi Hetilap",
issn = "0030-6002",
publisher = "Akademiai Kiado",
number = "39",

}

TY - JOUR

T1 - A hypophysisadenomák kezelése

AU - Mezősi, E.

AU - Nemes, Orsolya

PY - 2009

Y1 - 2009

N2 - According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.

AB - According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.

KW - Dopaminagonista

KW - Dopamine agonist

KW - Hypophysisadenoma

KW - Pituitary adenoma

KW - Prolactinoma

KW - Somatostatin analog

KW - Szomatosztatinanalóg

UR - http://www.scopus.com/inward/record.url?scp=70350776520&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350776520&partnerID=8YFLogxK

U2 - 10.1556/OH.2009.28584

DO - 10.1556/OH.2009.28584

M3 - Article

C2 - 19758960

AN - SCOPUS:70350776520

VL - 150

SP - 1803

EP - 1810

JO - Orvosi Hetilap

JF - Orvosi Hetilap

SN - 0030-6002

IS - 39

ER -