What are the treatments for corticotropinoma?

Many people don't know much about adrenocorticotropic hormone tumors. Most patients mainly show symptoms of suddenly becoming able to eat, and their bodies will also undergo many changes of varying degrees, such as changes in the face, body hair, and back. In the late stage, it usually has a serious impact on the respiratory system and is also very dangerous to life. At present, there are many ways to treat this disease. Let us learn about the treatments for adrenocorticotropic hormone tumors.

1. Surgical treatment: Once the diagnosis of Cushing's disease is established, the ideal first-choice treatment method is transsphenoidal microsurgical resection of the pituitary ACTH adenoma in order to achieve cure without causing permanent adrenal and pituitary insufficiency. Since ACTH microadenomas are mostly buried in the pituitary gland, it is recommended to perform a "rice"-shaped incision of the pituitary during surgery, which can prevent omissions and facilitate the exposure of the pituitary tissue around the lesion. In addition to tumor removal, subtotal resection of the peritumoral pituitary tissue (adolescents and adults who wish to have children) or subtotal resection (adults who do not wish to have children) should also be performed. Resection of the peritumoral pituitary tissue can improve the surgical efficacy. If no lesion is found during exploration, subtotal hypophysectomy should be performed rather than total hypophysectomy.

2. The effectiveness of radiotherapy for pituitary radiotherapy for Cushing's disease is 40% to 50%, and children are better than adults. It is currently used mostly for adjuvant therapy.

3. Drug treatment can be divided into two categories: drugs acting on the adrenal glands and central nervous system. The former include aminodole, metyrapone, dichlorobenzene, mitotane, ketoconazole, etomidate, etc.; the latter include cyproheptadine, bromocriptine, dimethylergonovine, ergonitrile, etc. The above drugs can only temporarily relieve symptoms. Once the drugs are stopped, the symptoms may relapse quickly. Moreover, the drugs are only effective for some patients. Drug therapy still has certain side effects and cannot be used for a long time. Therefore, it is only used for preoperative preparation and adjuvant treatment of delayed radiotherapy for patients with poor results after surgery and radiotherapy and for frail patients.

4. Nelson syndrome Nelson syndrome is a syndrome of pituitary-dependent Cushing's syndrome after bilateral adrenalectomy. After bilateral adrenalectomy, the hypothalamic CRH loses its negative feedback inhibition, resulting in excessive CRH, which stimulates the proliferation of the original pituitary ACTH adenoma or ACTH cells, causing the tumor to enlarge or produce tumors, and symptoms of tumor compression. In addition to symptoms of tumor compression and invasion, the main manifestation of Nelson syndrome is melanin deposition on the skin and mucous membranes due to excessive ACTH, which is particularly evident in skin folds. In terms of treatment, for large adenomas, pituitary ACTH adenoma can be removed transsphenoidally or transcranially, and radiotherapy can be used after surgery. At the same time, long-term medication of adrenal glucocorticoids is required to adjust the negative feedback inhibition of hypothalamic CRH.

The above is the introduction to the treatment of adrenocorticotropic hormone tumors that I would like to introduce to you here today. I hope that all patients have understood it in detail. Patients should not worry too much and should not be too blind in treatment. If there is a problem, seek treatment early. This disease is generally more common in females than in males. Especially pre-pubescent patients should pay more attention to avoid affecting their own development. I hope the above content is helpful to you.