So wowɔ akisikuru bi wɔ wo pituitary gland no so? (Pituitary Adenoma) Momma yensua ho ade!

So ɛtɔ mmere bi nso a wo ti yɛ wo yaw a ntease biara nnim? Anaasɛ wote nka sɛ w’aniwa ayɛ mmerɛw kakra, na wuntumi nhu nneɛma a efi nkyɛnkyɛn reba no yiye? Anaasɛ, so wowɔ ɔhaw bi a ɛnam nsakrae bi a ɛba wo nipadua mu nkwaadɔm mu? Ebia nea enti a saa nneɛma yi ba ne akisikuru ketewaa bi a ɛba wo pituitary gland no mu. Ɛnnɛ, yɛbɛka tebea yi a wɔfrɛ no `Pituitary Adenoma` ho asɛm kɔ akyiri. Mma ɛnhaw wo, eyi nyɛ kokoram.

Dɛn ne pituitary adenoma?

Sɛ yɛbɛka no tiawa a, pituitary adenoma yɛ akisikuru a ɛnyɛ kokoram (a ɛnyɛ papa) a ɛba wo pituitary gland mu. Ɛntrɛw nkɔ nipadua no afã afoforo te sɛ kokoram. Ɛno ne ade a ɛho hia sen biara. Nanso, bere a adenoma yi nyin no, etumi mia nneɛma te sɛ ntini ne mogya ntini a atwa ne ho ahyia no so. Ɛno ne bere a sɛnkyerɛnne ahorow no fi ase da adi.

Enti, dɛn ne saa pituitary gland yi?

Fa no sɛ, yɛn hwene akyi, a ɛbata amemene no ase, ``Hypothalamus``, ntini ketewaa bi a ne kɛse bɛyɛ sɛ pea wɔ hɔ. Ɛno ne nea wɔfrɛ no pituitary gland. Ɛwom sɛ ɛyɛ ketewaa de, nanso ɛyɛ adwuma titiriw bi wɔ yɛn nipadua mu. Saa ntini yi wɔ afã atitiriw abien:

• Anterior Lobe a Ɛwɔ Anim
• Akyi Akyi Ntini

Afã abien yi nyinaa ma hormone ahorow ahorow kɔ mogya no mu na woyi fi mu. Nkwammoaa mu nkwaadɔm te sɛ nnuru abɔfo a ɛhwɛ dwumadi ahorow a ɛwɔ yɛn nipadua mu so na ɛyɛ biako. Wɔnam mogya no mu na wɔde nkrasɛm a ɛho hia kɔ yɛn akwaa, ntini, ne ntini afoforo mu. Nnuru a ɛho hia a pituitary gland no yɛ no bi ni:

• Adrenocorticotropic hormone (ACTH anaa Corticotropin) a ɛma nipadua no yɛ adwuma yiye .
• Nnuru a ɛko tia nsu mu nsu (ADH anaa Vasopressin) .
• Ntini a ɛkanyan ntini (` FSH` ) .
• Nkwammoaa a ɛma obi nyin (`GH`) .
• Nnuru a ɛma mogya tu (`LH`) .
• Oxytocin (` Ɔkraman` ) .
• Prolactin a wɔde yɛ aduru
• Ntini a ɛkanyan thyroid (`TSH`) .

Ɛnyɛ eyi nko, na mmom pituitary gland no nso "kyerɛ" endocrine ntini afoforo a ɛwɔ yɛn nipadua mu sɛ ɛnyɛ hormone ahorow. Enti wubetumi ate ase sɛ sɛ ɔhaw bi wɔ saa pituitary gland yi ho te sɛ adenoma a, ebetumi aka hormone biako anaa hormone pii dwumadi.

Ɔkwan bɛn so na wohu adenoma ahorow yi mu nsonsonoe?

Nnuruyɛfo kyekyɛ pituitary adenomas mu ahorow abien titiriw: 1. Wogyina sɛ ebia ɛyɛ hormone anaasɛ ɛnnyɛ so:

• Adenoma a ɛyɛ adwuma/Nea ɛtwetwe:Nea ɛka ho no, adenoma ahorow yi ma wonya pituitary hormone biako anaa nea ɛboro saa . Enti, sɛnkyerɛnne ne tebea ahorow betumi aba a egyina hormone a wɔyɛ no boro so no so.
• Adenomas a ɛnyɛ adwuma/Ɛnyɛ adwuma: Saa adenomas yi ntumi nyɛ hormone. Nanso, sɛ wɔyɛ akɛse a, wobetumi de yare no ho sɛnkyerɛnne ahorow aba denam amemene no mmeae anaa ntini ahorow a ɛbɛn a wɔbɛmia so . Eyi ne adenoma a nnuruyɛfo taa hyia.

2. Sɛnea ne kɛse te:

• Microadenomas: Eyinom yɛ akisikuru a ɛyɛ nketewa sen milimita 10 (kyerɛ sɛ, sɛntimita 1).
• Macroadenomas: Eyinom yɛ akisikuru a ne kɛse boro milimita 10. Macroadenomas abu so bɛyɛ microadenomas mmɔho abien. Ɛda adi nso sɛ wɔde pituitary hormone biako anaa nea ɛboro saa (tebea a wɔfrɛ no hypopituitarism) a ɛba fam ba.

So wobu eyi sɛ amemene mu akisikuru?

Pituitary gland yɛ nhyehyɛe a ɛyɛ endocrine nhyehyɛe no dea ankasa, na wɔ mfiridwuma mu no ɛnyɛ amemene no fã. Ɛbata amemene no ase. Nanso, nnuruyɛfo bu pituitary adenomas sɛ amemene mu akisikuru bi . Pituitary adenomas yɛ amemene mu akisikuru titiriw no mu 10% pɛ.

Hena na ɔtaa nya eyinom? Ɛtaa ba dɛn?

Pituitary adenomas betumi aba wɔ mfe biara mu. Nanso, wɔtaa ba nnipa a wɔadi mfe 30 ne 40 so kɛse . Mmea nso taa nya bi kakra sen mmarima. Wɔtaa ba araa ma ɛyɛ akisikuru a enyin wɔ ti nhwi no mu nyinaa mu 10% kosi 15%. Sɛnea akontaabu kyerɛ no, nnipa 100,000 biara mu bɛyɛ 77 na wɔwɔ yare no. Nanso, nhwehwɛmufo gye di sɛ nnipa pii bio, ebia bɛyɛ 20%, benya bi wɔ wɔn asetra mu bere bi. Mpɛn pii, titiriw wɔn a wɔwɔ microadenomas (`microadenomas`), nni sɛnkyerɛnne biara, enti ɛkɔ a wontumi nhu.

Dɛn ne pituitary adenoma ho sɛnkyerɛnne ahorow?

Pituitary adenoma ho sɛnkyerɛnne betumi ayɛ soronko kɛse wɔ onipa biara ho. Egyina nneɛma pii so titiriw:

• Sɛ́ ebia adenoma no nyin kɛse na ɛsɛe pituitary gland no ankasa, anaasɛ ɛde ``mass effect'' ba nhyehyɛe ahorow a atwa ho ahyia no so.
• So ɛyɛ adenoma a ɛma hormone fi nipadua mu (`ɛyɛ adwuma`)? Sɛ saa a, sɛnkyerɛnne ahorow no begyina hormone ko a ɛde ba no so.

`Mass Effect` sɛnkyerɛnne a efi `Macroadenomas` (akuru akɛse) mu ba .

Adenomas akɛse (`Macroadenomas`) de sɛnkyerɛnne ahorow ba titiriw esiane nhyɛso a ɛwɔ ntini a atwa ho ahyia no so nti.

Susuw ho hwɛ, sɛ wode ade kɛse bi to dan ketewa bi mu a, ɛte sɛ nea baabi nnɔɔso mma nneɛma afoforo na nnipa ahyɛ hɔ ma.

• Aniwa ho haw ahorow:

Nnipa a wɔwɔ pituitary adenoma kɛse no mu bɛyɛ 40% kosi 60%Anisoadehu a ɛyera (anisoadehu a ɛyɛ kusuu, aniwa abien) ba. Eyi ba efisɛ adenoma no mia optic chiasm a ɛka aniwa ne amemene no bom no so. Eyi betumi ama obi ahwere aniwa a ɛwɔ akyi no, titiriw wɔ ɔfã no. Ɛte sɛ ɔpɔnkɔ a wahwere n’ani so wɔ n’afã abien no nyinaa.

• Ti a ɛyɛ yaw : .

Nnipa pii a wɔwɔ pituitary adenomas nwiinwii sɛ wɔn ti taa yɛ wɔn yaw. Ebia eyi fi akisikuru no a ɛrepiapia ntini a atwa ho ahyia no. Nanso, esiane sɛ mpɛn pii no nneɛma pii na ɛde tiyɛ ba nti, nneɛma foforo nso betumi de aba.

• Nnuru a Ɛma Nkwammoaa a Ɛnyɛ Den:

Adenomas akɛse (`Macroadenomas`) tumi sɛe pituitary gland ntini na ɛtew pituitary hormone biako anaa nea ɛboro saa a wɔyɛ so. Wɔfrɛ saa tebea yi `Hypopituitarism`. Nsɛnkyerɛnne a ɛba bere a wɔtew hormone biara so no nso gu ahorow.

• Sɛ LH ne FSH hormone so tew (`Hypogonadism`): ` Oestrogen` dodow a ɛwɔ mmea mu ne ` Testosterone` dodow a ɛwɔ mmarima mu no so tew. Eyi betumi de sɛnkyerɛnne ahorow te sɛ fifiri a ɛboro so , mmea awotwaa mu a ɛyɛ kusuu, ` Erectile Dysfunction` wɔ mmarima mu, anim ne nipadua mu nhwi a ɛso tew, mmarima baanu no nyinaa adwene a ɛsakra, nna ho akɔnnɔ a ɛso tew, ne ɔbrɛ kɛse aba.
• Sɛ TSH hormone dodow so tew (`Hypothyroidism`): Hormone dodow a thyroid ntini no yɛ no so tew. Eyi betumi ama yare no ho sɛnkyerɛnne te sɛ ɔbrɛ, akisikuru, koma a ɛbɔ brɛoo, honam ani a ɛyɛ kusuu, akwaa a ɛho ahonhon, ne nkate a ɛyɛ mmerɛw aba.
• Sɛ ACTH hormone no sua (`Adrenal Insufficiency`): Nipadua no mu hormone `Cortisol` a ɛyɛ no so tew. Eyi betumi de sɛnkyerɛnne ahorow te sɛ mogya mmoroso, akisikuru, ɔfe, yafunu mu yaw, ne aduan ho akɔnnɔ a ɛyera aba.
• GH (Growth Hormone Deficiency): Nsɛnkyerɛnne no gu ahorow gyina mfe a obi adi so. Mpanyimfo betumi abrɛ na wɔn ntini mu ayɛ den.

Adenomas a ɛyɛ adwuma ho sɛnkyerɛnne

Wɔ hormone biako anaa nea ɛboro saa a ɛba akyi no, adenoma a ɛyɛ adwuma betumi de sɛnkyerɛnne ne tebea ahorow a ɛfa hormone biara ho aba.

• Prolactinomas (a wɔsan frɛ no Lactotroph Adenomas): .

Saa adenomas yi ma hormone prolactin no dɔɔso dodo . Wɔfrɛ saa tebea yi hyperprolactinemia. Pituitary akisikuru 10 biara mu bɛyɛ 4 pɛ na ɛte sɛɛ. Eyi ne pituitary adenoma a abu so sen biara.Sɛ prolactin dodow kɔ soro a, awo nhyehyɛe no dwumadi a ɛfata wɔ mmea ne mmarima nyinaa mu no betumi asɛe.

• Awo a wontumi nwo yɛ tebea a ɛyɛ den ma mmarima ne mmea nyinaa sɛ wobenyinsɛn mma.
• Nufusu a ɛtɔ fi nufu mu bere mpo a onnyinsɛn (`Galactorrhea`).

• Adenoma a Ɛma Somatotroph:

Saa adenomas yi ma onyin hormone (`Growth Hormone` anaa `Somatotropin`) dodow a ɛboro so . Pituitary akisikuru 10 biara mu bɛyɛ 2 yɛ saa. Nsɛnkyerɛnne a eyi de ba no gu ahorow wɔ mfe a obi adi mu.

• Mpanyimfo: Tebea bi a ɛntaa nsi nanso emu yɛ den a wɔfrɛ no `Acromegaly` ba. Wɔ eyi mu no, nipadua no nnompe ne ntini ahorow nyin wɔ ɔkwan a ɛnteɛ so. Bere kɔ so no, nsa, anan, ne ti yɛ kɛse, na anim no nsɛso sesa. Ɛka asikre a ɛwɔ mogya mu no nso, na koma ntini no nso tumi yɛ kɛse.
• Mmofra ne mpanyimfo nkumaa: Tebea bi a wɔfrɛ no gigantism ba. Wɔnyin tenten wɔ ɔkwan a ɛnteɛ so esiane nyin hormone a ɛboro so nti.

• Adenoma a Ɛma Corticotroph:

Saa adenomas yi ma ACTH (adrenocorticotropic hormone) pii . Bɛyɛ pituitary akisikuru 10 biara mu 1 yɛ saa. ACTH hormone no kanyan adrenal ntini no ma ɛyɛ steroid hormone pii te sɛ cortisol. Eyi de Cushing’s Syndrome (cortisol a ɛboro so) ba.

• Mogya mmoroso.
• Ntini mu mmerɛwyɛ.
• Ɛnyɛ den sɛ wobɛbɔ akuru.
• Ntrɛwmu a ɛtrɛw (bɛboro cm 1) a ɛyɛ kɔkɔɔ (`Stretch Marks`) pue wɔ yafunu no so.
• Nnompe mu yare.
• Compression a ɛpaapae.
• Asikreyare a Ɛto so 2.

• Thyrotroph Adenomas a ɛma nipadua no yɛ adwuma:

Saa adenomas yi ma TSH (hormone a ɛkanyan thyroid) dɔɔso dodo . Eyinom ho yɛ na koraa. TSH kanyan thyroid ntini no ma ɛyɛ thyroid hormone pii. Eyi de `Hyperthyroidism` (thyroid tebea a ɛyɛ adwuma boro so) ba, a ɛma nipadua no mu nneɛma yɛ adwuma ntɛmntɛm.

• Koma a ɛbɔ a ɛkɔ soro.
• Mu duru a wɔtew so a ntease biara nnim.
• Nsu a ɛtaa yɛ mmerɛw.
• Fifiri a ɛrefifi.
• Nsa a ɛwosow.
• Brɛ.

Nea ɛho hia: Nneɛma afoforo pii wɔ hɔ a ɛde hyperthyroidism ba. Pituitary adenoma yɛ ade a ɛntaa nsi koraa.

• Gonadotroph Adenoma a ɛma nipadua no yɛ adwuma:

Saa adenomas yi ma gonadotropins (i.e., hormone LH ne FSH) dodow a ɛboro so. Eyi nso ho yɛ na koraa.

• Eyi betumi ama mmea anya brayɛ a ɛnkɔ so daa ne tebea horow te sɛ Ovarian Hyperstimulation Syndrome (OHSS).
• Mmarima betumi anya sɛnkyerɛnne ahorow te sɛ awotwaa a ɛtrɛw, nne a emu dɔ, ti nhwi a ɛtɔ (aso akyi), ne anim nhwi a enyin ntɛmntɛm.
• Mmofra nso betumi anya mmerantebere ne mmabaabere ntɛm.

Dɛn ne nneɛma a ɛde pituitary adenoma ba?

Nyansahufo da so ara nnim nea ɛde adenomas yi ba ankasa. Nanso, wosusuw sɛ adenomas binom ne nsakrae a ɛba kwa (`mutations`) wɔ awosu mu nkwaadɔm (`DNA`) a ɛwɔ yɛn nkwammoaa mu no wɔ abusuabɔ. Saa awosu mu nsakrae yi ma nkwammoaa a ɛwɔ pituitary gland no mu no nyin ntɛmntɛm na ɛyɛ kɛse. Ɛtɔ mmere bi a, wobetumi anya awosu mu nsakrae yi afi awofo hɔ akɔ mmofra hɔ (agyapade mu), anaasɛ ebetumi aba kwa koraa. Afei nso, wobetumi de pituitary adenomas nso abata awosu mu tebea horow bi a wɔntaa nhu ho . Nhwɛso ahorow bi ne:

• ``Multiple Endocrine Neoplasia a ɛto so 1 (MEN1)''.
• ``Multiple Endocrine Neoplasia a ɛto so 4 (MEN4)''.
• `Carney a ɛyɛ den`
• `X-LAG a ɛyɛ yareɛ`
• ``Succinate dehydrogenase a ɛfa abusua mu pituitary adenoma ho''.
• `Nneurofibromatosis a ɛyɛ 1`
• ``Von Hippel–Lindau ɔyare mmoawa''.

Obi a ɔwɔ awosu mu tebea yi wɔ asiane kɛse mu sɛ obenya pituitary adenoma. Nanso, ɛho hia sɛ yɛkae sɛ nnipa a wonni awosu mu tebea biara a ɛte saa nso betumi anya saa adenomas yi.

Ɔkwan bɛn so na nnuruyɛfo hu saa tebea yi?

Ɔkwan a wɔfa so hu pituitary adenoma no gu ahorow gyina adenoma ko a wowɔ ne sɛ ebia ɛde sɛnkyerɛnne ahorow reba anaa. Mpɛn pii no, obi a ɔwɔ adenoma a ɛma hormone (`Functioning Adenoma`) no, wodi kan hu sɛ ɔwɔ hormone a ɛnkari pɛ (e.g. `Cushing's Syndrome`, `Acromegaly`) a egyina sɛnkyerɛnne ahorow no so. Ɛno nkutoo na wohu adenoma no bere a wɔayɛ nea ɛde ba no mu nhwehwɛmu no. Eyi te saa efisɛ tebea horow pii a hormone a ɛboro so de ba no betumi anya nneɛma afoforo a ɛde ba a ɛka pituitary adenomas ho. Saa ara na yebetumi aka afa pituitary hormone a enni nipadua mu (`Hypopituitarism`) ho. Ɛtɔ da bi a, wohu pituitary adenoma sɛ `Incidental Finding` bere a wɔreyɛ ti scan (`Imaging Test`) ama tebea foforo. Adenoma dodow no ara a wohu te sɛ eyi no taa yɛ nketewa na ɛnyɛ adwuma.

Sɔhwɛ ahorow bɛn na wɔyɛ ma eyi?

Sɛ wo duruyɛfo susuw sɛ ebia wowɔ pituitary adenoma a, ɔbɛhwɛ wo sɛnkyerɛnne ahorow, w’ayaresa ho abakɔsɛm yiye, na wayɛ wo nipadua mu nhwehwɛmu. Nea ɛka ho no, wobetumi akamfo sɔhwɛ ahorow a edidi so yi mu biako anaa nea ɛboro saa akyerɛ:

• Mogya mu Nhwehwɛmu: Wobetumi agyina wo sɛnkyerɛnne ahorow so ahyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu de ahwɛ sɛnea pituitary hormone ahorow dodow te.
• Mfoninitwa Sɔhwɛ: MRI (Magnetic Resonance Imaging) scan a wɔde hwɛ ti anaa`CT (Computed Tomography)` scan betumi ama wɔayɛ nneɛma a ɛwɔ ti no mu no ho mfonini a emu da hɔ. Saa nhwehwɛmu ahorow yi betumi asi so dua sɛ ebia pituitary adenoma bi wɔ hɔ ne sɛnea ɛsõ. `MRI` scan ne sɔhwɛ a ɛfata na ɛyɛ mmerɛw sen biara ma eyi.
• Aniwa mu Nhwehwɛmu: Sɛ wowɔ aniwa mu haw biara a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ w’aniwa mu nhwehwɛmu. Saa sɔhwɛ yi ho hia efisɛ pituitary adenomas akɛse betumi de aniwa mu haw aba denam aniwa ntini a ɛka aniwa no ne amemene no bom no a ɛtwetwe no so.

Ɔkwan bɛn so na wɔsa pituitary adenoma?

Akwan atitiriw abiɛsa na ɛwɔ hɔ a wɔfa so sa pituitary adenomas: oprehyɛn, nnuru, ne mframa a wɔde sa yare. Ɛtɔ mmere bi a, wobetumi de akwan yi mu biako anaa nea ɛboro saa adi dwuma abom. Esiane sɛ ɛsono obiara adenoma ne ne tebea nti, wo ne w’aduruyɛfo kuw no betumi abom ahu ayaresa nhyehyɛe a eye ma wo.

Oprehyɛn a wɔyɛ de yi adenoma fi hɔ

Sɛ wowɔ adenoma bi a ɛde hormone ahorow a ɛnkari pɛ anaasɛ ɛreka w’ani so a, ɛda adi sɛ wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn nyi adenoma no nyinaa anaa ne fã bi mfi hɔ. Ebia ɛho behia sɛ woyɛ oprehyɛn bɛboro biako a egyina adenoma no kɛse ne sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den so. Nnuruyɛfo a wɔyɛ oprehyɛn taa de oprehyɛn kwan bi a wɔfrɛ no `Transsphenoidal Surgery` na ɛyɛ saa adeyɛ yi. Nea ɛka eyi ho ne sɛ wɔbɛfa hwene no mu na wɔafa sphenoid sinus (beae a ɛyɛ tokuru wɔ hwene no akyi, amemene no ase) mu akɔdu pituitary gland no mu na wɔayi adenoma no afi hɔ. Wɔnam saa kwan yi so yi pituitary tumors bɛyɛ 95% fi hɔ. Ɛyɛ adeyɛ a ahobammɔ nnim koraa. Nanso, sɛ adenoma no sõ dodo sɛ wobetumi ayi afi hwene no mu anaasɛ ɛwɔ baabi a ɛyɛ den a, ebia ɛsɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn no yɛ oprehyɛn a ɛfa ne ti no ho. Eyi yɛ adeyɛ a ɛntaa nsi wɔ pituitary adenomas ho.

Nnuru a wɔde sa yare

Wobetumi de nnuru adi pituitary adenomas ahorow bi so, titiriw prolactinomas , na wɔatew so. Mfiase no, wɔde aduru a ɛma dopamine te sɛ Cabergoline (Dostinex®) anaa Bromocriptine (Cycloset®) sa nnipa a wɔwɔ prolactinomas (eyinom ne nea abu so sen biara) yare asram pii.

Asɛmpa no ne sɛ wɔ bɛyɛ 80% mu no, saa nnuru yi brɛ prolactinoma no ase na ɛma prolactin hormone dodow san kɔ sɛnea na ɛte kan no.

Sɛ nnuru no ntumi nyɛ adwuma anaasɛ ɛyɛ adenoma foforo a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ no oprehyɛn.

Mframa a Wɔde Yɛ Ayaresa

Mframa a wɔde sa yare no de X-ray a ahoɔden kɛse wom di dwuma de sɛe adenoma nkwammoaa, na ɛtew akisikuru no so anaasɛ ɛmma ɛnnyin. Stereotactic Radiosurgery a Wɔde Ma Pituitary Adenomas(e.g. `Gamma Knife`®) Wɔde ɔkwan soronko bi a ɛyɛ pɛpɛɛpɛ a wɔde mframa a ano yɛ den sa yare di dwuma. Wɔ eyi mu no, wɔde mframa a ano yɛ den pii fi mmeae ahorow kɔ adenoma no so, na ɛmma ntini a ɛwɔ apɔwmuden a atwa ho ahyia no sɛe. Wɔde saa kwan yi di dwuma ma mmeae a aka wɔ oprehyɛn akyi anaasɛ wɔ nsɛm a oprehyɛn ntumi nyɛ yiye mu.

Dɛn ne ayaresa no mu nsunsuanso bɔne?

Sɛnea ɛte wɔ aduruyɛ biara mu no, pituitary adenoma a wɔsa no betumi anya nsunsuanso bɔne bi.

• Wɔ oprehyɛn ne/anaasɛ mframa a wɔde sa yare akyi no, nnipa a wɔwɔ pituitary adenomas no mu bɛyɛ 60% betumi anya `Hypopituitarism` (pituitary hormone biako anaa nea ɛboro saa a wɔyɛ so tew). Ɛwom sɛ eyi yɛ nkwa nna nyinaa tebea de, nanso nnuru a wɔde si hormone ananmu betumi aboa nkurɔfo ma wɔatra ase sɛnea ɛsɛ.
• Nsɛnnennen a ebetumi afi oprehyɛn mu aba:
• Mogya a ɛretu.
• Cerebrospinal Fluid (CSF) leak (nsuo a ɛfiri hwene mu ba).
• Meningitis (nyarewa a ɛba ntini a ɛkata amemene no so).
• Asikreyare Insipidus (nsu a wɔtow boro so ne sukɔm a ɛboro so esiane hormone a ɛko tia nsu a ɛba nipadua mu a enni hɔ nti).
• Nneɛma bɔne a ɛtaa ba wɔ nnuru a wɔde yɛ dopamine agonist ma prolactinoma ho ne: tiyɛ, akisikuru, ɔfe, adwenemhaw, ne ɛtɔ mmere bi a nneyɛe a ɛhyɛ obi so.
• Nneɛma bɔne a ebetumi afi mframa a wɔde sa yare mu aba:
• Pituitary hormone a enni nipadua mu (ebetumi aba bere a bere kɔ so no).
• Awo a Ɛsɛe.
• Anisoadehu a ɛyera ne amemene no mu ntini a ɛsɛe (ɛho yɛ na yiye).
• Ebia akisikuru foforo bɛba wɔ beae koro no ara wɔ mfe pii akyi wɔ ayaresa akyi (ɛho yɛ na yiye).

So wobetumi asiw adenomas yi a ɛbɛhyehyɛ no ano?

Nea ɛyɛ awerɛhow no, biribiara nni hɔ a wubetumi ayɛ de asiw pituitary adenomas ano. Mpɛn pii no, ɛba kwa. Nanso, ebia wɔne awosu mu tebea horow a wɔntaa nhu a yɛadi kan aka ho asɛm no bi wɔ abusuabɔ. Sɛ abusua muni bi a ɔbɛn no (onua, onuawa, anaa ɔwofo) wɔ awosu mu tebea te sɛ eyi a, wubetumi ne wo duruyɛfo akasa afa awosu mu afotu ne nhwehwɛmu ho ahwɛ sɛ wo nso wowɔ yare no anaa. Sɛ woyɛ saa a, wo duruyɛfo betumi ahwɛ wo yiye na wahu adenoma biara a ɛba ntɛm na wasa.

Dɛn ne tebea yi ho nkɔmhyɛ?

Adenoma a ɛwɔ pituitary mu, kyerɛ sɛ, sɛnea wo ho bɛtɔ wo ne w’akwahosan daakye gyina adenoma kɛse ne ne su so, ne ayaresa a wɔde ma wo .

Asɛmpa no ne sɛ, mpɛn pii no, sɛ woyi adenoma no fi hɔ koraa anaasɛ wɔde ayaresa di so a, ayarefo betumi atra ase a edi mũ na apɔwmuden bio.

Wɔ tebea horow bi mu no, ayaresa betumi atew hormone ahorow a pituitary gland no yɛ so. Sɛ eyi ba a, ebia ebehia sɛ wonom nnuru a wɔde si hormone ananmu wo nkwa nna nyinaa na ama woatumi de asi hormone a ɛso atew no ananmu. Ɛtɔ mmere bi a adenomas tumi san ba bio. Eyi kyerɛ sɛ ebia ebehia sɛ wɔsan sa wɔn yare wɔ bere bi akyi. Akontaabu kyerɛ sɛ nnipa a wɔwɔ adenomas a ɛnyɛ adwuma no mu bɛyɛ 18% ne nnipa a wɔwɔ prolactinoma bɛyɛ 25% betumi ahia ayaresa bio daakye. Enti, ɛho hia yiye sɛ wo ne wo duruyɛfo bɛkɔ so adi nkitaho daa na woakɔhwɛ wo daa.

So ebetumi aba sɛ wo ne pituitary adenoma bɛtra ase?

Yiw, wubetumi. Sɛ pituitary adenoma no sua na ɛmfa sɛnkyerɛnne biara mma a, wubetumi ne no atra ase sɛnea ɛsɛ. Nokwarem no, nnipa pii hu sɛ wɔwɔ adenoma bere a wɔayɛ wɔn ti mu nhwehwɛmu esiane biribi foforo nti nkutoo. Nanso, sɛ adenoma no kɔ so nyin anaasɛ efi ase de sɛnkyerɛnne ahorow ba a, akyinnye biara nni ho sɛ wubehia ayaresa. Sɛ wowɔ pituitary adenoma kɛse ne/anaasɛ ɛyɛ adwuma (a ɛma hormone) a, akyinnye biara nni ho sɛ wubehia ayaresa. Eyi te saa efisɛ pituitary adenomas bi betumi anya w’akwahosan ne w’asetra mu nkɛntɛnso kɛse.

Sɛ wɔansa a, nsɛnnennen bɛn na ebetumi aba?

Sɛ wɔansa a, pituitary adenomas binom – titiriw adenomas akɛse (`Macroadenomas`) ne adenomas a ɛyɛ adwuma (`Secreting`) – betumi de akwahosan ho haw a emu yɛ den aba . Saa akwahosan ho haw ahorow yi gyina hormone ko a adenoma no yi fi mu no so kɛse (yɛadi kan aka eyi ho asɛm wɔ `Symptoms` ɔfã no mu). Ɔhaw a ɛntaa nsi nanso ɛyɛ hu kɛse a ɛba wɔ pituitary adenomas a wɔansa ho ne `Pituitary Apoplexy`. Eyi yɛ `Aduruyɛ mu Ntɛmntɛm`. Eyi ba bere a mogya tu kɔ pituitary gland no mu anaasɛ efi mu ba no. `Pituitary Apoplexy` taa fi mogya a ɛtɔ kɔ pituitary adenoma mu. Akisikuru no sõ mpofirim, na ɛsɛe pituitary gland no. Dodow a adenoma no yɛ kɛse no, dodow no ara na asiane a ɛwɔ hɔ sɛ obi benya `Pituitary Apoplexy` no yɛ kɛse. `Pituitary Apoplexy` ho sɛnkyerɛnne taa da adi ntɛmntɛm yiye na ebetumi de nkwa ato asiane mu . Nsɛnkyerɛnne titiriw a ɛkyerɛ ne sɛ:

• Tiyɛ a emu yɛ den yiye (te sɛ tiyɛ a enye koraa a manya pɛn wɔ m’asetra mu).
• Anisoadehu mmɔho abien anaasɛ aniwa a wontumi mma so esiane aniwa no ntini a entumi nyɛ adwuma yiye nti.
• Aniwa a ɛyera wɔ nkyɛnkyɛn anaasɛ aniwa a ɛyera koraa wɔ aniwa biako anaa abien no nyinaa mu.
• Adrenal insufficiency a emu yɛ den ma mogya mmoroso, akisikuru, na ɔfe.
• Nipasu mu nsakrae (e.g., adwene mu naayɛ) esiane amemene no anim ntini a ɛyɛ teateaa mpofirim wɔ amemene no mu nti.

Pituitary apoplexy yɛ tebea a ɛntaa nsi, nanso ɛyɛ aniberesɛm yiye. Sɛ wuhu saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, frɛ nnuruyɛfo a wɔhwɛ ntɛmpɛ so (te sɛ 911) ntɛm ara anaa ma obi mfa wo nkɔ ayaresabea dan a ɛbɛn wo a wɔhwɛ ntɛmpɛ so.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

• Sɛ wowɔ aniwa mu haw biara (anisoadehu a ɛyɛ kusuu, aniwa mprenu, aniwa a ɛwɔ akyirikyiri a ɛso tew) ne/anaasɛ wo ti a ɛyɛ wo yaw a ɛkɔ so anaasɛ ɛsan ba bio (titiriw wɔ wo moma so fã) a, kɔ oduruyɛfo nkyɛn na ka ho asɛm kyerɛ wɔn.
• Sɛ wɔahu sɛ wowɔ pituitary adenoma dedaw a, ɛho behia sɛ wokɔ wo duruyɛfo nkyɛn daa na wahwɛ sɛnea adenoma no te na woahwɛ ahu sɛ ayaresa no reyɛ adwuma yiye.

Nea etwa to no, kae nneɛma yi:

Ɛyɛ ade a ɛfata koraa sɛ wobɛte ehu ne dadwen nka bere a wuhu sɛ wowɔ akisikuru no. Nanso, asɛmpa a ɛfa pituitary adenomas ho ne sɛ ne fã kɛse no ara (bɛboro 99%) nyɛ kokoram (ɛnyɛ bɔne) na wɔ nsɛm dodow no ara mu no, ayaresa betumi ama nneɛma pa aba. Kae sɛ wo duruyɛfo ne wo hokafo wɔ w’akwahosan a eye sen biara a wubenya mu. Enti, ntwentwɛn wo nan ase da sɛ wobɛbɔ wo duruyɛfo amanneɛ wɔ yare no ho sɛnkyerɛnne, wo ho a ɛnyɛ wo dɛ, anaa nsɛmmisa biara a ebia wowɔ wɔ w’ayaresa no ho. Sɛ wonya nsɛm a ɛfata ne ayaresa a ɛfata a, akyinnye biara nni ho sɛ wubetumi adi tebea yi ho dwuma yiye.