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HNO

, Volume 67, Issue 4, pp 307–318 | Cite as

Differenzialdiagnostik und Therapie der Hypophysenadenome

  • M. HlaváčEmail author
  • F. Sommer
  • G. Karpel-Massler
  • R. Wirtz
  • T. Hoffmann
  • A. Paľa
CME
  • 151 Downloads

Zusammenfassung

Hypophysenadenome gehören zu den häufigsten primären intrakraniellen Tumoren. Die Tumoren können alle Hormone des Hypophysenvorderlappens produzieren und dadurch endokrinologische Erkrankungen verursachen. Durch Kompression der Hypophyse, der benachbarten Hirnnerven und Gehirnstrukturen können eine Hypophyseninsuffizienz, Hirnnervenausfälle und andere neurologische Störungen auftreten. Sehstörungen, typischerweise mit einer bitemporalen Hemianopsie, gehören zu den häufigsten primären Symptomen. Die Diagnostik erfordert eine interdisziplinäre Zusammenarbeit mehrerer beteiligter Disziplinen. Bis auf das Prolaktinom wird bei allen symptomatischen Hypophysenadenomen eine transnasal-transsphenoidale Resektion angestrebt. Prolaktinome können medikamentös mit Dopaminagonisten therapiert werden. Bei Hypophyseninsuffizienz ist die Einleitung einer adäquaten Hormonsubstitution essenziell. Langfristige Verlaufskontrollen sind ein wesentlicher Bestandteil des Therapiekonzepts.

Schlüsselwörter

Neurologische diagnostische Verfahren Hypophysektomie Endokrine Diagnoseverfahren Diabetes insipidus, neurogener Hypophysenradiotherapie 

Differential diagnosis and treatment of pituitary adenomas

Abstract

Pituitary adenomas are among the most common primary brain tumors. These tumors can produce all hormones of the anterior pituitary and thus cause endocrine diseases. Compression of the pituitary gland, the surrounding cranial nerves, or brain structures can lead to hypopituitarism, cranial nerve deficits, or diverse neurological symptoms. Visual impairment, typically with bitemporal hemianopsia, is the most common cardinal symptom. The diagnostic workup requires broad interdisciplinary cooperation. With the exception of prolactinoma, the treatment of choice for symptomatic pituitary adenoma is transnasal transsphenoidal resection. For prolactinoma, dopamine agonistic therapy is the primary treatment. Adequate hormone replacement therapy is essential in cases of hypopituitarism. Long-term follow-up is a vital part of the treatment concept.

Keywords

Neurological diagnostic techniques Hypophysectomy Endocrine diagnostic techniques Diabetes insipidus, neurogenic Pituitary irradiation 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Hlaváč, F. Sommer, G. Karpel-Massler, R. Wirtz, T. Hoffmann und A. Paľa geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • M. Hlaváč
    • 1
    Email author
  • F. Sommer
    • 2
  • G. Karpel-Massler
    • 1
  • R. Wirtz
    • 1
  • T. Hoffmann
    • 2
  • A. Paľa
    • 1
  1. 1.Klinik für NeurochirurgieUniversität UlmUlmDeutschland
  2. 2.Klinik für Hals-Nasen-OhrenheilkundeUniversität UlmUlmDeutschland

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