Pituitary adenoma yog cov qog tsim ntawm qhov zoo. Nws yog los ntawm cov qog nqaij hlav nyob rau hauv lub anterior pituitary caj pas. Los ntawm kev saib xyuas, pituitary adenoma yog qhia los ntawm ophthalmic-neurological (qhov muag tsis pom kev, mob taub hau, ob lub qhov muag pom thiab lawv qhov nqaim) thiab endocrine-metabolic syndromes, qhov twg, nyob ntawm seb hom kab mob, acromegaly, kev sib deev tsis ua haujlwm, hypogonadism., gigantism, galactorrhea tuaj yeem kuaj tau, hyper- thiab hypothyroidism, hypercortisolism.
Kev kuaj mob yog tsim los ntawm cov ntaub ntawv tau txais los ntawm CT ntawm Turkish eeb, angiography ntawm lub hlwb ntawm lub taub hau, radiography, MRI, ophthalmological thiab hormonal kuaj. Pituitary adenoma (ICD code D35-2) yog kho nrog hluav taws xob, radiosurgery thiab transcranial lossis transnasal tshem tawm.
YTus essence ntawm pathology
Pituitary tsonyob rau hauv lub hauv paus ntawm lub pob txha taub hau, nyob rau hauv qhov tob ntawm lub Turkish eeb. Nws muaj lobes tom qab thiab anterior. Pituitary adenoma yog ib qho qog pituitary uas pib hauv cov ntaub so ntswg ntawm lub lobe. Nws tsim rau 6 cov tshuaj hormones uas tswj kev ua haujlwm ntawm cov qog endocrine: somatotropin, lutropin, thyrotropin, prolactin, adrenocorticotropic hormone, follitropin. Judging los ntawm cov txheeb cais, pathology tshwm sim nyob rau hauv tsuas yog kaum feem pua ntawm tag nrho cov qog nyob rau hauv lub pob txha taub hau uas tshwm sim nyob rau hauv neurology. Feem ntau tshwm sim hauv cov neeg mob hnub nyoog nruab nrab (30 txog 40 xyoo).
Kev faib kab mob
Qhov nyuaj ntawm kev faib cov kab mob no yog qhov anatomically, lub caj pas pituitary belongs rau lub paj hlwb, tab sis los ntawm kev ua haujlwm ntawm qhov pom, mus rau endocrine.
Pituitary adenoma raug cais raws li cov hauv qab no:
1. Adenomas yog hormonally nquag ua haujlwm (adenomas ntawm hom plurihormonal muaj peev xwm tso tawm ntau cov tshuaj hormones, piv txwv li, prolactosomatotropinoma). Feem ntau hom yog:
- somatotropinoma;
- Ythyrotropinoma;
- gonadotropinoma;
- Yprolactinoma;
- corticotropinoma.
2. Hormonally inactive adenomas yog subdivided nyob rau hauv morphological zog:
- " ntsiag to" adenomas corticotrophic, somatotrophic (hom 1 thiab 2), lactotrophic, thyrotrophic, gonadotrophic;
- null cell adenomas;
- oncocytomas.
3. Nyob ntawm qog loj:
- microadenoma: tsis ntau tshaj kaum millimeters;
- picoadenoma: tsis ntau tshaj peb;
- macroadenoma: ntau dua kaum millimeters txoj kab uas hla;
- giant: 40-50+.
4. Raws li cov yam ntxwv ntawm qhov chaw nyob rau hauv relation mus rau lub Turkish eeb thiab kev loj hlob:
- endosellar kev loj hlob, uas yog, hauv lub eeb;
- infrasellar (kev taw qhia ntawm kev loj hlob poob);
- supraellar (nce);
- retrosellar (rov qab, uas yog nyob rau hauv lub plhaub tawv ntawm lub hlwb ntawm lub hlwb);
- antesellar (loj hlob rau hauv lub voj voog, kab lattice maze);
- laterosellar (mus rau hauv kab noj hniav ntawm lub cavernous sinus, sideways, mus rau hauv fossa hauv qab lub tuam tsev, thiab lwm yam).
Yog tias thaum lub sijhawm kho mob cov tsos mob ntau dhau ntawm cov tshuaj hormones pituitary qhov kev kuaj mob tsis raug tsim thiab cov neoplasm tseem loj tuaj, cov tsos mob ntawm lub paj hlwb thiab ophthalmological tshwm sim, cov kev hloov pauv tuaj yeem tshwm sim vim kev coj ntawm cov qog loj hlob.
Yog vim li cas thiaj pom
Hauv kev tshawb fawb txog kev kho mob niaj hnub no, cov kab mob thiab etiology ntawm pituitary adenoma tseem yog qhov kev tshawb fawb. Nws feem ntau lees paub tias adenoma tuaj yeem tshwm sim nyob rau hauv kev cuam tshuam ntawm ntau yam ua rau muaj kev cuam tshuam, xws li neuroinfection (brucellosis, taub hau hlwb abscess, tuberculosis, poliomyelitis, neurosyphilis, meningitis, cerebral malaria, encephalitis, thiab lwm yam), craniocerebral trauma, tsis zoo. cuam tshuam rau fetus thaum lub sij hawm ntawm intrauterine kev loj hlob. Tsis ntev los no, nws tau pom tias nyob rau hauv cov poj niam, pathology tej zaum yuav yog vim kev siv cov tshuaj tiv thaiv qhov ncauj ntev.
Pituitary adenoma hauv cov menyuam yaus tsim muaj tsawg zaus. Cov neoplasms no feem ntau yog benign.
Vim qhov tseeb tias lub caj pas pituitary tswj hwm cov tshuaj hormones hauv lub cev, txawm tias muaj kev hloov pauv me me hauv nws cov qauv, cuam tshuam rau tus menyuam lub siab, nws lub peev xwm mloog zoo, thiab kev loj hlob tuaj yeem pib.
Adenomas feem ntau ua rau mob taub hau thiab pom teeb meem.
Cov kws tshawb fawb pom tias tus kab mob hauv qee kis tshwm sim vim muaj kev txhawb nqa hypothalamic ntau dhau ntawm lub cev, uas yog cov tshuaj tiv thaiv hauv kev teb rau thawj qhov kev txo qis hauv cov tshuaj hormonal ntawm cov qog endocrine nyob rau hauv periphery. Ib qho zoo sib xws rau nws cov tsos yog ua tau nrog hypothyroidism thiab thawj hypogonadism.
Nws yog dab tsi - adenoma ntawm pituitary caj pas ntawm lub hlwb, peb piav qhia. Nws tshwm sim li cas?
Signs of disease
Pituitary adenoma yog qhov chaw kho mob tau tshwm sim raws li cov kab mob ophthalmic-neurological tshwm sim los ntawm lub siab ntawm cov qog loj hlob ntawm cov qauv hauv pob txha taub hau nyob hauv thaj tsam ntawm Turkish eeb. Nrog rau qhov xwm txheej hormonally nquag ntawm adenoma, qhov chaw tseem ceeb hauv daim duab kho mob yuav yog cov kab mob endocrine-metabolic. Kev hloov pauv ntawm tus neeg mob feem ntau tsis cuam tshuam nrog hyperproduction ntawm pituitary tropic hormone, tab sis nrog lub hom phiaj ntawm lub cev uas nws cuam tshuam thiab ua kom muaj zog. Cov tsos mob ntawm endocrine-exchange syndrome yog ncaj qha txiav txim los ntawm tus yam ntxwv ntawm cov qog. Txawm li cas los xij, ntawm qhov tod tes, pathology tuaj yeem nrog qee yam ntapanhypopituitarism, uas tshwm sim vim kev puas tsuaj ntawm cov ntaub so ntswg pituitary los ntawm cov qog loj hlob. Cov tsos mob ntawm pituitary adenoma tshwm nyob rau hauv ntau yam variations.
Hypopituitarism
Qhov tshwm sim zoo li hypopituitarism yog qhov tshwm sim hauv cov qog ntawm qhov loj. Nws tshwm sim vim kev puas tsuaj ntawm cov ntaub so ntswg pituitary tshwm sim los ntawm cov qog o. Cov kab mob pathological no tshwm sim los ntawm kev txo qis libido, kev sib deev tsis ua haujlwm, impotence, hypogonadism thiab hypothyroidism. Cov neeg mob kuj muaj qhov hnyav nce, kev nyuaj siab, tsis muaj zog, thiab tawv nqaij qhuav.
Cov tsos mob ntawm pituitary adenoma yog qhov tsis txaus siab.
Ophthalmo-neurological syndrome
Cov tsos mob ntawm Ophthalmo-neurological cov tsos mob nrog rau cov kab mob pathology nyob ntawm qhov ntau thiab cov kev taw qhia ntawm kev loj hlob neoplasm. Feem ntau nws yog mob taub hau, qhov muag tsis pom kev, diplopia thiab kev hloov pauv hauv qhov muag pom. Mob taub hau tshwm vim yog lub siab ua haujlwm ntawm Turkish eeb los ntawm pituitary adenoma. Nws yog npub, nws tsis cuam tshuam los ntawm txoj hauj lwm ntawm lub cev, tsis muaj xeev siab. Cov neeg mob uas muaj tus kab mob no feem ntau yws tias qhov mob taub hau tsis yog ib txwm daws tau los ntawm kev siv tshuaj loog. Nws yog feem ntau nyob hauv cheeb tsam ntawm lub cev nqaij daim tawv thiab pem hauv ntej, hauv qab ntawm lub orbit. Tej zaum yuav muaj mob taub hau nrog pituitary adenoma, vim yog qhov loj hlob ntawm cov qog, los yog hemorrhage hauv nws cov ntaub so ntswg.
eeb. Ntev-ntev pathology tuaj yeem ua rau lub paj hlwb atrophy. Nrog rau sab nraud ntawm kev loj hlob ntawm adenoma, nws thiaj li compresses cov ceg ntawm peb, plaub, tsib thiab thib rau cov hlab ntsha ntawm pob txha taub hau. Vim li no, qhov tsis xws luag hauv oculomotor muaj nuj nqi tshwm sim, uas yog, ophthalmoplegia, thiab diplopia (ob lub zeem muag). Tej zaum yuav muaj qhov txo qis ntawm qhov pom kev pom. Thaum ib tug pituitary adenoma hlob mus rau hauv qab ntawm lub sella turcica thiab kis mus rau lub sphenoid los yog ethmoid sinus, ib tug neeg tsim qhov ntswg congestion, uas ua raws li lub chaw kho mob ntawm qhov ntswg hlav los yog sinusitis. Thaum coj mus rau pem hauv ntej, cov qauv ntawm lub hypothalamus puas lawm, thiab tus neeg mob txoj kev nco qab kuj yuav cuam tshuam.
Cov tsos mob ntawm pituitary adenoma yog qhov tseem ceeb kom paub txog lub sijhawm.
Endocrine-metabolic syndrome
Prolactinoma yog ib qho pituitary adenoma uas secretes prolactin. Nws yog nrog los ntawm irregularities nyob rau hauv tus poj niam lub cev ntas, infertility, amenorrhea thiab galactorrhea. Cov tsos mob zoo li no tuaj yeem tshwm sim hauv kev sib xyaw ua ke lossis hauv kev sib cais. Kwv yees li 30% ntawm cov neeg mob prolactinoma muaj teeb meem hauv daim ntawv ntawm pob txuv, seborrhea, anorgasmia, rog rog, hypertrichosis. Hauv cov txiv neej, ua ntej ntawm tag nrho cov, cov tsos mob ntawm ophthalmo-neurological tshwm sim, tawm tsam uas gynecomastia, txo libido, impotence thiab galactorrhea yog ua tau.
Somatotropinoma yog pituitary adenoma uas tsim cov tshuaj hormones loj hlob, hauv cov neeg laus nws pom nws tus kheej hauv daim ntawv ntawm acromegaly, hauv cov menyuam yaus - gigantism. Ntxiv nrog rau cov yam ntxwv skeletal transformations nyob rau hauv tib neeg,txhim kho kev rog thiab ntshav qab zib mellitus, nce qhov loj ntawm cov thyroid caj pas (nodular lossis diffuse goiter), feem ntau tsis nrog rau kev ua haujlwm tsis zoo. Feem ntau muaj hyperhidrosis, hirsutism, ntau daim tawv nqaij greasiness thiab cov tsos ntawm nevi, papillomas thiab warts ntawm nws. Polyneuropathy tuaj yeem txhim kho, uas yog nrog los ntawm paresthesias, mob thiab txo qis hauv qhov rhiab heev ntawm cov ceg tawv ntawm lub periphery.
Corticotropinoma yog ib qho adenoma uas tsim ACTH thiab tau txiav txim siab nyob rau hauv yuav luag ib puas feem pua ntawm cov neeg mob Itsenko-Cushing's disease. Cov qog manifests raws li cov cim classic ntawm hypercortisolism, nce daim tawv nqaij pigmentation vim ntau lawm ntawm melanocyte-stimulating hormone nrog rau ACTH. Tej zaum yuav muaj kev puas siab puas ntsws. Nws yog tus yam ntxwv ntawm ntau yam ntawm adenomas uas muaj kev nyiam hloov pauv hom malignant nrog ntxiv metastasis. Nrog rau qhov tshwm sim thaum ntxov ntawm cov kab mob endocrine, cov qog tuaj yeem kuaj pom txawm tias ua ntej cov tsos mob ntawm lub paj hlwb tshwm sim vim nws txoj kev loj hlob.
Gonadotropinoma - xws li adenoma uas tsim cov tshuaj gonadotropic thiab muaj cov yam ntxwv tsis tshwj xeeb, feem ntau txiav txim siab los ntawm qhov muaj cov tsos mob ntawm cov tsos mob ntawm lub paj hlwb. Daim duab kho mob tuaj yeem suav nrog kev sib xyaw ua ke ntawm galactorrhea (vim nce prolactin tso tawm los ntawm cov ntaub so ntswg pituitary uas nyob ib puag ncig adenoma) thiab hypogonadism.
YThyrotropinoma yog pituitary adenoma uas secretes TSH. Nrog nws cov cim tseem ceeb, nws manifests nws tus kheej nyob rau hauv daim ntawvhyperthyroidism. Txawm li cas los xij, nrog qhov tshwm sim thib ob, ib tus tuaj yeem hais txog hypothyroidism.
YKev kuaj mob pituitary adenoma
Cov kev kuaj mob tseem ceeb rau kev kuaj mob yog X-ray thiab kuaj biochemical, uas yog, craniography, MRI tomography, xam tomography, radioimmunological txoj kev. Yog tias muaj kev xav tsis thoob ntawm adenoma, ua ntej ntawm tag nrho cov, X-ray craniography (ob qhov projections), tomography ntawm thaj tsam ntawm lub eeb yog ua los txiav txim siab cov yam ntxwv ntawm cov txheej txheem volumetric intrasellar, uas ua rau muaj kev hloov pauv hauv cov pob txha. cov qauv (osteoporosis), nrog rau kev puas tsuaj ntawm lub nraub qaum ntawm lub eeb, thiab lwm yam. Cov yam ntxwv ntawm lub ntsej muag yog qhov bypass xwm ntawm nws hauv qab. Txhawm rau txiav txim siab qhov muaj qog thiab nws cov qauv tshwj xeeb (cystic, khoom, thiab lwm yam), qhov loj thiab kev coj ntawm kev loj hlob, suav tomography yog siv, thiab nrog kev sib piv. Nrog pituitary adenoma, ua tsaug rau MRI tomography, nws muaj peev xwm ua tau nyob rau qee kis los tsim kom muaj kev loj hlob ntawm cov qog. Yog tias muaj kev xav tsis thoob ntawm nws txoj kev loj hlob sab nraud (uas yog, mus rau lub qhov ntswg qhov ntswg), cerebral angiography yuav tsum tau ua. Los ntawm txoj kev pneumocisternography, kev hloov pauv ntawm chiasmatic cisterns, nrog rau cov tsos mob ntawm lub eeb Turkish khoob, tau txiav txim siab.
Ib txoj kev kuaj mob tshwj xeeb uas muaj kev nkag siab zoo rau pituitary adenoma yog xov tooj cua tiv thaiv kab mob ntawm cov tshuaj hormones pituitary hauv cov ntshav.
Kev kuaj mob zoo li no yuav tsum tau ua kom nyuaj. Suspicion ntawm adenomaYog hais tias tus neeg mob muaj ophthalmic neurological defects los yog endocrine-metabolic syndrome. Qhov tshwm sim ntawm lub siab lub ntsws ntawm cov neeg mob, qhov nyuaj ntawm kev tshawb nrhiav kev tshawb nrhiav, kev loj hlob qeeb, muaj peev xwm ntawm overdiagnosis thiab kev kho mob benign ntawm ntau adenomas yuav tsum tau ceev faj thiab tactful mob siab rau cov neeg mob mus rau qhov kev xeem.
Tus kws tshaj lij yuav tsum ua ntej kom paub tseeb tias cov kab mob endocrine-metabolic tsis yog tshwm sim los ntawm kev siv ntau yam tshuaj (antidepressants, antipsychotics, tshuaj tiv thaiv kab mob uas ua rau galactorrhea, lossis corticosteroids uas cuam tshuam rau cov tsos mob ntawm cushingoidism., thiab lwm yam).) lossis cov teebmeem neuro-reflex (nce palpation los ntawm tus neeg mob ntawm cov qog mammary, muaj cov tshuaj tiv thaiv kab mob hauv tsev menyuam, mob ntev hom adnexitis), uas tuaj yeem pab tsim cov reflex galactorrhea.
Nws yog qhov yuav tsum tau txiav txim siab thawj qhov hypothyroidism, uas yog ib qho ua rau galactorrhea. Tom qab ntawd, kev txiav txim siab ntawm qhov concentration ntawm tropic pituitary cov tshuaj hormones hauv cov ntshav, nrog rau kev tsom xam x-ray ntawm pob txha taub hau, tau sau tseg. Kev nce siab hauv qhov concentration ntawm cov tshuaj no, nrog rau cov tsos mob ntawm cov kab mob pituitary adenoma, lees paub qhov kev kuaj mob.
Kev ntsuam xyuas tshuaj kho mob tshwj xeeb kuj tseem siv los kuaj pom qhov txawv txav rau cov tshuaj pharmacological los ntawm cov ntaub so ntswg adenomatous. Yog tias xav tias muaj adenoma, tus neeg mob yuav tsum raug xa mus raukev sab laj nrog ophthalmologist. Hauv kev kawm txog kev pom kev pom thiab pom kev pom, nrog rau kev tsom xam ntawm cov nyiaj, kev cuam tshuam ntawm qhov muag lossis chiasmal syndrome tuaj yeem tsim tau, thiab qee zaum, qhov tsis xws luag hauv cov hlab ntsha oculomotor.
Nrog qhov qis qis ntawm cov tshuaj hormones pituitary hauv cov ntshav thiab qhov qhia tau nyob rau hauv kev kuaj X-ray ntawm lub xub ntiag ntawm volumetric tsim nyob rau hauv thaj tsam ntawm Turkish eeb, MRI, xam tomography, cerebral angiography thiab pneumocisternography yog. siv rau pituitary adenoma.
Kev kuaj mob ntawm qhov sib txawv yog nqa tawm nrog cov qog uas tsis ua haujlwm hormonally, uas nyob hauv thaj tsam ntawm lub eeb Turkish, nrog pituitary-hypothalamic insufficiency (tsis yog qog keeb kwm), nrog cov qog uas tsis muaj. nyob rau hauv lub caj pas pituitary thiab tsim cov tshuaj hormones peptide. Qhov no neoplasm yuav tsum tau sib txawv los ntawm lub syndrome ntawm ib tug khoob Turkish eeb, uas yog yus muaj los ntawm qhov tshwm sim ntawm ib tug ophthalmic neurological syndrome.
Pituitary adenoma kho li cas?
Txoj kev kho mob ntawm pathology
Kev kho mob tuaj yeem siv feem ntau hauv kev cuam tshuam rau me me prolactinomas. Nws yog nqa tawm nrog prolactin antagonists, piv txwv li, Bromkriptin. Yog hais tias lub adenoma me me, ces txoj kev siv hluav taws xob tuaj yeem siv los cuam tshuam cov qog: tej thaj chaw deb proton lossis hluav taws xob kho, gamma therapy, stereotactic radiosurgery, uas yog, kev taw qhia ntawm cov khoom siv hluav taws xob ncaj qha rau hauv cov qog nqaij hlav.
Cov neeg mob uas muaj adenoma loj lossis nrog cov teeb meem tshwm sim (tsis pom kev, hemorrhage,Cov tsos mob ntawm lub cyst nyob rau hauv lub hlwb ntawm lub taub hau), ib tug kws kho mob neurosurgeon yuav tsum tau sab laj los txiav txim seb yuav tshem tawm pituitary adenoma. Kev ua haujlwm kom tshem tawm cov neoplasm tuaj yeem ua tau los ntawm txoj kev transnasal siv cov txheej txheem endoscopic. Macroadenomas raug tshem tawm transcranally, uas yog, nrog kev pab ntawm craniotomy.
Kev kho ntawm pituitary adenoma tuaj yeem ua rau muaj teeb meem. Xav paub ntau ntxiv tom qab.
Kev tshwm sim thiab qhov xav tau teeb meem
- Kev pom kev tsis zoo.
- Kev raug mob rau cov ntaub so ntswg zoo pituitary.
- Impaired ncig hauv hlwb.
- Kev mob.
- Liquorrhea.
Yog siv txoj kev endoscopic, ces qhov tshwm sim tsis zoo tom qab phais raug txo qis.
Tus neeg mob nyob hauv tsev kho mob tom qab lub pituitary adenoma raug tshem tawm los ntawm txoj kev endoscopic, tsis ntev yog tias tsis muaj teeb meem thaum lub sijhawm ua haujlwm. Lub sijhawm hloov pauv: hauv 1-3 hnub.
Rau txhua tus neeg mob tom qab tso tawm, qhov kev kho mob rov qab tau tsim los ntawm tus kheej kom tsis txhob rov muaj tus kab mob.
Dab tsi tos ib tus neeg muaj pituitary adenoma tom qab phais?
Huab cua
Txawm hais tias nws yog ib qho benign neoplasm, raws li nws loj, zoo li lwm cov qog hlwb ntawm lub taub hau, nws yuav ua rau mob vim yog compression ntawm cov qauv anatomical uas nyob ib puag ncig nws. Qhov loj ntawm cov qog kuj cuam tshuam qhov ua tau ntawm nws qhov kev tshem tawm tiav. Pituitary adenoma tshaj obcentimeters nyob rau hauv txoj kab uas hla yog txuam nrog qhov yuav rov tshwm sim tom qab phais. Nws tuaj yeem tshwm sim hauv tsib xyoos.
Tsis tas li, qhov kev tshwm sim ntawm pituitary adenoma nyob ntawm nws ntau yam. Piv txwv li, nrog microcorticotropinomas, hauv 85% ntawm cov neeg mob, kev kho dua tshiab ntawm kev ua haujlwm ntawm endocrine system tag nrho tom qab kev phais kho mob tau sau tseg. Hauv cov neeg mob prolactinoma thiab somatotropinoma, daim duab no qis dua - los ntawm 20 mus rau 25%. Qee cov ntaub ntawv qhia tias tom qab kev kho mob phais, qhov nruab nrab, 67% rov qab, nrog rov ua dua hauv 12% ntawm cov neeg mob. Qee zaum, nrog hemorrhage rau hauv adenoma, kho tus kheej tshwm sim, uas yog tshwj xeeb tshaj yog nrog prolactinomas.
Qhov tshwm sim ntawm pituitary adenoma yog qhov paub zoo ua ntej.
cev xeeb tub thiab adenoma
Yog tias prolactin-secreting adenomas, thaum tsis muaj kev kho mob txaus, cov ntsiab lus no feem ntau tsis sib haum. Vim qhov tso tawm ntawm prolactin ntau dhau los ntawm cov qog, tus poj niam tsis xeeb tub. Nws tshwm sim tias qhov neoplasm zoo li no tau tshwm sim ncaj qha thaum cev xeeb tub.
Lwm hom, uas cov ntsiab lus ntawm prolactin hauv cov ntshav tseem nyob hauv ib txwm txwv, tsis txhob cuam tshuam nrog kev xeeb menyuam. Pituitary adenoma phais tsis tau ua thaum lub sijhawm no.
Yog tias kuaj pom tus kab mob zoo li no, tus neeg mob yuav tsum mus ntsib kws kho mob gynecologist, kws kho mob neurosurgeon thiab endocrinologist thoob plaws lub cev xeeb tub.
Kev Tiv Thaiv
Kev tiv thaiv, nws raug pom zoo kom tsis txhob tshwm sim ntawm kev raug mob ntawm lub hlwb, raws sijhawmkho ntau yam kab mob sib kis los tiv thaiv kab mob hauv lub hlwb, thiab tsis txhob siv cov tshuaj tiv thaiv qhov ncauj ntev dhau.
Yog tias kuaj pom cov kab mob neurological, ophthalmological thiab hormonal txawv txav, koj yuav tsum nrhiav kev pab kho mob uas tsim nyog tam sim.
Peb tau tshuaj xyuas adenoma ntawm lub qog pituitary ntawm lub hlwb. Tam sim no qhov tseeb yog dab tsi.
