原文

https://vcahospitals.com/know-your-pet/pituitary-tumors

Pituitary Tumors
垂体肿瘤

By Debbie Stoewen DVM, MSW, RSW, PhD; Christopher Pinard, DVM

What is the pituitary gland?
什么是垂体？

The pituitary gland is a tiny organ, smaller than a pea, located at the base of the brain. It is responsible for producing specialized chemicals (or hormones) that influence many other organ systems in the body.

垂体是一个很小的器官，比豌豆还小，位于大脑的底部。

它负责产生影响身体许多其他器官系统的特殊化学物质(或激素)。

These hormones can affect the adrenal glands (responsible for producing stress hormones), the thyroid gland (responsible for producing thyroid hormone), and the parathyroid glands (responsible for regulating calcium), as well as the pancreas and other tissues in the body. The pituitary gland is often referred to as the ‘master gland’ because of its importance in controlling other parts of the endocrine (hormone) system.

这些激素可以影响
肾上腺(负责产生应激激素)、
甲状腺(负责产生甲状腺激素)
和甲状旁腺(负责调节钙)，
以及胰腺和身体的其他组织。

垂体通常被称为“主腺”，
因为它在控制内分泌(激素)系统的其他部分方面很重要。

What is pituitary tumor? 
什么是垂体肿瘤？

A pituitary tumor develops as the result of abnormal, replication or growth of the cells that make up the pituitary gland. Tumors may develop from the functional glandular tissue (i.e., the tissue that produces hormones) – these are called functional pituitary tumors – or from the nonfunctional parts of the pituitary gland. About 10% of pituitary tumors in dogs are nonfunctional.

垂体肿瘤是由于构成脑下垂体的细胞的异常复制或生长而产生的。

肿瘤可能从
功能性的腺体组织(即产生激素的组织)发展而来——这些称为功能性垂体肿瘤
——或者从垂体的非功能性部分发展而来。

大约10%的犬垂体瘤是非功能的。

What causes this cancer?
是什么引起了这种癌症？

The reason why a particular pet may develop this, or any tumor or cancer, is not always straightforward. Very few tumors and cancers have a single known cause. Most seem to be caused by a complex mix of risk factors.

特定宠物可能患上这种疾病或任何肿瘤或癌症的原因并不总是明了的。

很少有肿瘤和癌症有单一的已知病因。

大多数似乎是由一系列复杂的风险因素引起的。

Although there are no known dietary or environmental causes for pituitary tumors, certain breeds appear to be predisposed, including Miniature Poodles, Boxer Dogs, Boston Terriers, and Dachshunds. While no breed predisposition has been identified in cats, as in dogs, tumors tend to develop in those that are middle-aged to older.

虽然没有已知的饮食或环境因素导致垂体肿瘤，
但某些品种似乎好发，
包括 迷你贵宾犬、拳师犬、波士顿梗犬和腊肠犬。

虽然没有发现猫和犬一样的品种倾向，
但肿瘤往往发生在中年到老年的猫身上。

What are the signs of a pituitary tumor?
垂体肿瘤的症状有哪些？

The signs of a pituitary tumor depend on the region of the pituitary gland that is affected. If the tumor develops from the functional glandular tissue, the signs will be associated with the effects of these hormones.

垂体肿瘤的症状取决于受影响的垂体区域。

如果肿瘤从功能性的腺体组织发展而来，
出现的症状将与这些激素的作用有关。

In dogs, the most common pituitary tumor affects the region that produces adrenocorticotrophic hormone (ACTH). Excess ACTH causes the adrenal glands to make too much cortisol (a naturally produced steroid) leading to a condition called hyperadrenocorticism or Cushing’s disease. The clinical signs of Cushing’s disease include increased appetite and thirst, increased urination (sometimes leading to accidents in the house), lethargy, weakness, panting, heat intolerance, hair loss, obesity, and a pot-bellied appearance.

在犬，
最常见的垂体肿瘤会影响产生促肾上腺皮质激素(ACTH)的区域。

过量的ACTH会导致肾上腺产生过多的皮质醇(一种自然产生的类固醇)，
导致肾上腺皮质亢进或库兴氏病。

库兴氏病的临床症状包括食欲亢进（多食）和渴觉亢进（多饮），排尿增加（多尿）(有时导致在家里发生非预料之内的排尿)，嗜睡，无力，喘气，不耐热，脱毛，肥胖和梨形腹的外观（腹围增大）。

"The signs of a pituitary tumor depend on the region of the pituitary gland that is affected."

垂体肿瘤的症状取决于受影响的垂体区域。

In cats, the most common pituitary tumor affects the region that produces somatotropin or growth hormone (GH). An increase in GH causes a condition called acromegaly. Because acromegaly causes insulin-resistant diabetes mellitus, signs of diabetes such as increased thirst, urination, and appetite are seen. In addition, excess GH causes excess growth of the legs, paws, chin, skull, and other parts of the body, and weight gain, causing the cat’s physical appearance to change.

在猫中，最常见的垂体肿瘤会影响产生促生长素（somatotropin）或生长激素(GH)的区域。

生长激素的增加会导致肢端肥大症（acromegaly）。

由于肢端肥大症会导致胰岛素抵抗型糖尿病（insulin-resistant diabetes mellitus），
因此会出现渴觉亢进（多饮）、排尿增多（多尿）和食欲增加（多食）等糖尿病症状。

此外，过量的生长激素会导致腿、爪子、下巴、头骨和身体其他部位的过度生长，体重增加，导致猫的外表发生变化。

If the tumor develops from a nonfunctional part of the pituitary gland, the size of the mass may cause neurological signs such as lethargy, decreased appetite, behavioral changes, blindness, seizures, and gait abnormalities.

如果肿瘤从垂体的非功能部分发展而来，
肿块的大小可引起一些神经学症状，
如嗜睡、食欲减退、行为改变、失明、抽搐发作和步态异常。

How is this type of cancer diagnosed? 
这种类型的癌症如何诊断？

If your dog has signs of Cushing’s disease, your veterinarian will run routine and specialized blood and urine tests. If the test results are inconclusive, retesting may be needed 3 to 6 months later. Once the disease is confirmed, however, additional blood tests are usually done to determine whether the cause is a tumor of the pituitary gland or of the adrenal gland. As well, the adrenal glands can be evaluated using abdominal x-rays or ultrasound, and the pituitary gland with more sophisticated methods of diagnostic imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI).

如果狗狗有库兴氏病的症状，
你的兽医会进行常规和专门的血液和尿液检查。

如果检查结果还不确定，
可能需要在3至6个月后重新测试。

然而，一旦疾病被确诊，通常还要进行额外的血液检查，
以确定病因是垂体肿瘤还是肾上腺肿瘤引起的。

同样，
肾上腺可以用腹部X光片或超声波进行评估，
垂体可以用更复杂的诊断成像方法进行评估，
如计算机断层扫描(CT)或磁共振成像(MRI)。

If your cat has signs of acromegaly, although blood and urine tests will be helpful, the most definitive diagnostic test is a CT scan or MRI of the pituitary region.

如果猫咪有肢端肥大症的症状，
虽然血液和尿液检查会有所帮助，
但最确定的诊断检查是垂体区域的CT扫描或MRI扫描。

How does this cancer typically progress?
这种癌症的病情一般会如何发展？

As pituitary tumors are nearly always benign, they only grow locally. They do not metastasize (spread to other areas of the body). If the tumor is functional and your pet is not treated, the associated condition will continue or worsen, and your pet’s health will deteriorate. If the tumor is nonfunctional and your pet is not treated, the neurological signs will continue or worsen, or become more difficult to control, as the tumor grows.

由于垂体肿瘤大部分都是良性的，它们通常只在局部生长。

它们一般不会转移(扩散到身体的其他部位)。

如果肿瘤是功能性的，而你的宠物没有得到治疗，
相关的情况将会继续或恶化，你的宠物的健康状态将会恶化。

如果肿瘤是无功能的，而你的宠物没有得到治疗，
随着肿瘤的生长，神经症状将继续或恶化，或变得更难控制。

What are the treatments for this type of tumor?
这种类型的肿瘤该如何治疗？

The choice of treatment depends on whether the pituitary tumor is functional or nonfunctional.

治疗的选择取决于垂体肿瘤是功能性的还是非功能性的。

Many functional tumors can be managed with medication. Mitotane and trilostane are two medications that have been shown to be effective in dogs with Cushing’s disease. Radiation therapy is another option; new techniques are very effective and have few side effects. Medications may still be necessary for a few months after radiation therapy. Surgical techniques to remove pituitary tumors in dogs are being studied, but surgery is not a widely available option. Your veterinarian can recommend the best treatment for your dog based on your dog’s condition.

许多功能性肿瘤可以用药物治疗。

米托坦（Mitotane）和曲洛斯坦（trilostane）是两种药物，
已证明对患有库兴氏病的犬有效。

放射治疗是另一种选择；
一些新技术非常有效，而且几乎没有副作用。

在放射治疗后的几个月里，药物治疗仍然是必要的。

目前正在研究切除犬脑垂体肿瘤的手术技术，
但手术并不是一种广泛可行的选择（不是哪里都能做的）。

兽医可以根据狗狗的情况为狗狗推荐最好的治疗方法。

Managing the clinical signs of diabetes by increasing the dosage of insulin is the most conservative and most common method for managing cats with acromegaly. Radiation probably offers the greatest chance of successful treatment, improving both insulin resistance and neurological signs. The rate of tumor shrinkage, however, is slow (more than 3 years) and there is risk of damaging the pituitary gland and nearby brain tissue. Surgery to remove the pituitary gland (called a transsphenoidal hypophysectomy) is possible, and in some veterinary medical centers it has become the primary treatment, but it has significant risks and requires lifelong hormone supplementation to compensate for the loss of pituitary function.

通过增加胰岛素剂量来控制糖尿病的临床症状
是治疗肢端肥大症的猫最保守和最常见的方法。

放疗可能提供了最大的成功治疗机会，可以改善胰岛素抵抗和神经症状。

然而，肿瘤缩小的速度很慢(超过3年)，并且有损害垂体和邻近脑组织的风险。

手术切除垂体(称为经蝶窦垂体切除术 transsphenoidal hypophysectomy)是可能的，
在一些兽医中心，它已成为主要的治疗方法，
但它有很大的风险，并且需要终生补充激素来补偿垂体功能的丧失。

The most common treatment for nonfunctional pituitary tumors is radiation therapy. The goal is to specifically target the enlarged pituitary and reduce the size for as long as possible. Radiation therapy in veterinary medicine has progressed with advances in technology that allow veterinary oncologists to specifically target a tissue with minimal effects to the surrounding tissue.

无功能垂体肿瘤最常用的治疗方法是放射治疗。

目标是专门针对增大的垂体，并尽可能长时间地缩小肿物的大小。

随着技术的进步，
兽医肿瘤学家可以在对周围组织影响最小的情况下，
专门针对某个组织进行放射治疗。

Is there anything else I should know?
我还应该了解一些什么别的事情吗？

The outlook for dogs with Cushing’s disease is good, with an average life expectancy of 2 years with medication. At least 10% of dogs that are treated live 4 more years. Dogs treated with radiation may survive 2–5 years.

患有库兴氏病的犬的预期发展是良好的，
保守药物治疗的平均预期寿命为2年。

至少有10%接受治疗的犬能多活4年。

接受放射治疗的犬可以存活2-5年。

"In all cases, the long-term outlook tends to improve with early diagnosis and treatment."

“在所有病例中，早期诊断和治疗往往会改善长期前景。”

The outlook for cats with untreated acromegaly is fair to good in the short-term, using various medications to treat the signs. Because this does not address the cause of the condition, however, the long-term outlook is relatively poor. Most cats will die of congestive heart failure, chronic kidney failure, or signs related to the growing pituitary tumor.

对于患有肢端肥大症的猫来说，
使用各种药物治疗这些症状，
短期内的预期是相当好的。

然而，由于这并没有解决这种情况的病因，
长期预期是相对较差的。

大多数猫会死于充血性心力衰竭、慢性肾衰竭或与垂体肿瘤增大有关的症状。

In all cases, the long-term outlook tends to improve with early diagnosis and treatment.

在所有病例中，通过早期诊断和治疗，长期预后是趋于改善的。

Contributors: Debbie Stoewen DVM, MSW, RSW, PhD; Christopher Pinard, DVM

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