Central nervous system tumors

Drug therapy

Drug treatment (low cost, no wound, no pain, short recovery period)

Bromocriptine, cabergoline, octreotide, cyproheptyl and other drugs are used in the treatment of pituitary tumors to inhibit hormone secretion and reduce hormone levels to normal, which has the advantages of low cost and non-trauma, and is suitable for most prolactinomas

In all types of pituitary tumors, drug therapy is mainly suitable for those with aggressive prolactin adenomas, or as a complementary treatment after surgical treatment, usually effective in restoring vision for a short time. In particular, it should be noted that pituitary prolactinoma is one of the important causes of female infertility, and in the treatment of infertility, the tumor diameter <1.0cm(microadenoma) should also be treated with drugs.

Prolactinoma

The treatment of prolactinoma depends on the size of the tumor and whether hyperprL causes symptoms. Drug treatment (dopamine agonists) is used, and bromocryptotine is the main treatment in our hospital. If the drug effect is poor or there is drug resistance, transsphenoid sinus (minimally invasive) surgery can be considered.

Pituitary tumor and infertility

The treatment of pituitary adenoma is mainly transsphenoidal minimally invasive surgery, combined with drug, biological and other methods for the comprehensive treatment of female and male infertility, mainly suitable for refractory infertility caused by pituitary tumor factors.

Surgical treatment

Surgical treatment (good tumor exposure, low recurrence rate, good curative effect, high radical cure rate)

Surgical treatment is mainly minimally invasive surgery and craniotomy. It is suitable for patients with non-functional macroadenomas and secretory pituitary adenomas (except PRL adenomas), and most pituitary adenomas can be completely resected. Through microscopy, intraoperative navigation, neuroendoscopy and other techniques to improve the safety of surgery, to achieve total surgical resection, postoperative recurrence is not easy.

Minimally invasive surgery mainly adopts the transsphenoidal approach, which is suitable for the treatment of microadenoma. It is easy to recover, leaves no scar after surgery, and alleviates patients' fear of craniotomy. It is a common surgical method at present. Craniotomy offers hope for the complete treatment of patients with large and complex pituitary tumors. With the improvement of surgical equipment and technology, the risk of craniotomy is reduced and the surgical safety is improved.

In recent years, endoscopic pituitary adenoma resection has developed rapidly, and the popularity of transsphenoidal approach to pituitary adenoma resection has gradually reduced the proportion of transcranial surgery. However, due to the different growth and expansion directions of pituitary tumors, these two approaches cannot replace each other and each has its own value. Craniotomy should be performed for patients with highly extended supersella tumors and giant pituitary tumors that develop supersella and do not enlarge the sella.

The average cost of pituitary tumor surgery: about 30,000 to 50,000 yuan

Length of stay: about 2 weeks

Nonfunctional pituitary adenoma

The treatment of non-functional pituitary adenoma includes surgical treatment, radiotherapy and medical treatment. For surgical treatment, radiotherapy can be added to patients with poor surgical effect or postoperative recurrence, and medical treatment can be tried for patients with no obvious symptoms of tumor compression.

Growth hormone tumor

The treatment of growth hormone adenoma is surgical resection. At present, there is no clear and effective drug treatment. The main purpose of surgical treatment of growth hormone adenoma is to completely remove the tumor as far as possible and reduce the GH value to normal.

Thyroid stimulating hormone tumor

Thyrotropin tumors are rare pituitary tumors, accounting for about 0.5% of all pituitary tumors. The treatment is surgical resection of the tumor, usually by transsphenoidal surgery. If the tumor is large with suprasellar expansion, transcranial surgery should be considered.

Adrenocorticotropin tumor

The treatment of adrenocorticotropin tumor is surgery, and there is no clear and effective drug treatment at present. To achieve a cure without permanent adrenal and pituitary insufficiency, the ideal treatment is transsphenoidal microsurgical resection.