内分泌学 | 实时焦点:垂体聚焦 2021-04-01

Experimental and Clinical Endocrinology & Diabetes



德国内分泌学学会(The German Society of Endocrinology)长期以来一直关注垂体的科学和临床问题。垂体工作组“Arbeitsgemeinschaft Hypophyse”是一个跨学科的特别小组,重点推进垂体疾病的诊断和治疗。德国内分泌学学会及其Arbeitsgemeinschaft Hypophyse小组与其它协会一起发表了S2K临床指南《临床激素非活性垂体瘤的诊断和治疗(Diagnosis and therapy of clinically hormonally inactive pituitary tumors)》,并以英文发表于本刊。


First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors

Deutschbein T et al.

Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.