뇌하수체 종양 내부비 병
Pituitary-Tumor Endocrinopathies
NEJM 4/5/2020에서 퍼온글
Pituitary adenomas account for approximately 15% of intracranial tumors.
What is the most common secretory tumor of the pituitary?
Prolactinomas are the most common secretory tumor, accounting for up to 60% of all pituitary adenomas and more than 75% of pituitary adenomas in women. Microprolactinomas, which have a female:male ratio of 20:1, are usually stable and slow-growing, with continued growth after diagnosis in less than 15% of cases.
Are all types of prolactinomas more common in women than in men?
Most patients with a pituitary mass and a serum prolactin level exceeding 150 ng per milliliter (reference range, <20) are found to have a prolactinoma. A prolactin level of more than 250 ng per milliliter is usually diagnostic of a macroprolactinoma, and the tumor mass usually correlates with the serum prolactin level. Large prolactinomas (>10 mm in diameter) that are aggressive account for less than 5% of tumors and are characterized by very high prolactin levels (>1000 ng per milliliter) and a male:female ratio of 9:1. In a study involving 45 men and 51 women with prolactinomas, the tumors in the men were larger than those in the women (mean [±SD] diameter 26±2 mm vs. 10±1 mm) and grew more aggressively, with a mean serum prolactin level of 2789±572 ng per milliliter in men versus 292±74 ng per milliliter in women.