译丨犬垂体巨腺瘤 Pituitary Macroadenoma in Dogs
原文
https://vcahospitals.com/know-your-pet/pituitary-macroadenoma-in-dogs#:~:text=Pituitary%20macroadenomas%20are%20more%20common%20in%20dogs%2C%20although,depend%20on%20whether%20the%20tumor%20is%20producing%20hormones.
Pituitary Macroadenoma in Dogs
犬垂体巨腺瘤
What is a pituitary macroadenoma?
什么是垂体巨腺瘤？
Pituitary macroadenomas are large, non-cancerous (benign) tumors of the pituitary gland (a pea-sized organ at the base of the brain responsible for producing hormones that influence many organ systems in the body). These tumors are typically greater than ½ inch in diameter, though there is some subjective variation in the definition of macroadenoma depending on the animal’s skull size. Pituitary macroadenomas are more common in dogs than in cats.
垂体巨腺瘤是垂体(位于大脑底部的一个豌豆大小的器官，负责产生影响身体许多器官系统的激素)的大的非癌性(良性)肿瘤。
这些肿瘤通常直径大于1/2英寸，尽管根据动物的颅骨大小对巨腺瘤的定义有一些主观差异。
垂体巨腺瘤在犬身上比在猫身上更常见。
笔记📒
- 非癌性，良性
- 直径一般>1.2cm（0.5 英寸）
- 犬比猫常见
These tumors may be functional (hormone-secreting) or non-functional (do not secrete hormones), and their effects depend on whether the tumor is producing hormones. The effects of non-functional pituitary macroadenomas are directly related to the physical pressure that the growing tumor places on surrounding brain structures, while the effects of functional macroadenomas are dependent on the type of hormones produced by the tumor.
这些肿瘤可能是功能性的(分泌激素的)或非功能性的(不分泌激素的)，
它们的影响取决于肿瘤是否产生激素。
非功能性垂体巨腺瘤的影响与肿瘤生长对周围脑结构的物理压力直接相关，
而功能性巨腺瘤的影响则取决于肿瘤产生的激素类型。
笔记📒
- 功能性，非功能性
"In most cases, pituitary macroadenomas are functional tumors."
多数病例的垂体巨腺瘤是非功能性的
In most cases, pituitary macroadenomas are functional tumors. The most common functional pituitary macroadenomas in dogs release a hormone known as adrenocorticotrophic hormone (ACTH). This hormone triggers the adrenal glands to release cortisol, leading to a condition called Cushing’s disease. Cushing’s is a common metabolic disease in dogs, especially in Boxers, Pugs, Bulldogs, Boston Terriers, and Dachshunds. (See handout “Cushing’s Disease in Dogs” for more information.)
在大多数情况下，垂体巨腺瘤是功能性肿瘤。
犬最常见的功能性垂体大腺瘤释放一种激素，称为促肾上腺皮质激素(ACTH)。
这种激素触发肾上腺释放皮质醇，导致一种叫做库兴氏病的疾病。
库兴氏病是一种常见的犬类代谢疾病，
尤其是拳师犬、巴哥犬、斗牛犬、波士顿梗犬和腊肠犬。
(更多信息见讲义“Cushing’s Disease in Dogs”。)
笔记📒
- 功能性 → 犬最常见释放 → 促肾上腺皮质激素 ACTH → 皮质醇 → 库兴氏病 Cushing’s disease
- 拳师犬，巴哥犬，斗牛犬，波士顿梗犬，腊肠犬
What are the clinical signs of a pituitary macroadenoma?
垂体巨腺瘤的临床症状有哪些？
In dogs with a functional pituitary macroadenoma causing Cushing’s disease, signs include increased appetite, increased thirst and urination, alopecia (hair loss), dry skin, blackheads, and a pendulous (sagging) belly. Dogs with Cushing’s disease also have a weakened immune system, so recurrent or chronic infections may be observed.
患有功能性垂体巨腺瘤导致库兴氏病的犬，
症状包括食欲增加（多食），渴觉亢进（多饮）和排尿增加（多尿），脱毛(掉毛增多)，皮肤干燥，黑头和腹围增大(肚子松垂)。
患有库兴氏病的犬也有较弱的免疫系统，因此可能会观察到复发性或慢性的感染。
笔记📒
- 功能性垂体巨腺瘤的症状
-- 食欲增加（多食）
-- 渴觉亢进（多饮）
-- 排尿增加（多尿）
-- 脱毛(掉毛增多)
-- 皮肤干燥
-- 黑头
-- 腹围增大(肚子松垂)
-- ···
- 免疫系统弱化 → 易感染
"Dogs with Cushing’s disease also have a weakened immune system, so recurrent or chronic infections may be observed."
患有库兴氏病的犬也有较弱的免疫系统，因此可能会观察到复发性或慢性的感染。
A dog with a non-functional pituitary macroadenoma may show signs related to the tumor’s compression of nearby brain structures. Several optic (eye) structures are located in the area of the pituitary gland; therefore, visual defects are often seen with pituitary macroadenomas. Additionally, these tumors can interfere with the production of hormones that help to concentrate urine. If this happens, a dog can develop increased thirst and urination and a condition known as diabetes insipidus. In many cases, however, initial signs may be vague, such as lethargy and decreased appetite, progressing over time to walking in circles or seizures.
患有无功能垂体巨腺瘤的犬可能表现出与肿瘤压迫附近脑结构有关的症状。
多个视觉(眼睛)结构位于垂体区域附近;
因此，垂体巨腺瘤常伴有视觉缺陷。
此外，这些肿瘤会干扰有助于浓缩尿液的激素的产生。
如果发生这种情况，狗狗可能会渴觉增加（多饮）和排尿增加（多尿），
一种尿崩症（diabetes insipidus）。
然而，在许多情况下，
最初的症状可能是不明确的，如嗜睡和食欲下降，
随着时间的推移，发展到绕圈行走或抽搐发作。
笔记📒
- 非功能性垂体巨腺瘤的症状
-- 视觉缺陷
-- 多饮
-- 多尿
-- 尿崩症
-- 非特异性症状 - 嗜睡，食欲下降
-- 神经症状 - 转圈，抽搐发作
-- ···
How is a pituitary macroadenoma diagnosed?
垂体巨腺瘤如何诊断？
Definitive diagnosis of a pituitary macroadenoma requires brain imaging with advanced techniques such as CT or MRI. This imaging is performed under anesthesia at a specialty hospital or university.
垂体巨腺瘤的明确诊断需要采用高阶的脑成像技术，如CT或MRI。
这种成像扫描需要在麻醉下在专科医院或大学里进行。
How is a pituitary macroadenoma treated?
垂体巨腺瘤如何治疗？
The most effective treatment for a pituitary macroadenoma is surgical removal, though it is uncommon in animals due to the cost and difficult nature of the surgery. If surgery is performed, the resolution of clinical signs is rapid and complete.
垂体巨腺瘤最有效的治疗方法是手术切除，
但由于手术的成本和难度，这种方法在动物中并不常见。
如果进行手术，临床症状的解决是迅速和完全的。
笔记📒
- 治疗
-- 手术治疗
--- 临床症状的解决是迅速和完全的
"Radiation therapy is a more commonly used method to shrink pituitary tumors."
放射治疗是缩小垂体肿瘤的一种更常用的方法。
Radiation therapy is a more commonly used method to shrink pituitary tumors. Radiation is administered several times per week for four to six weeks with the goal of decreasing the size of the tumor and minimizing clinical signs. Radiation therapy typically does not completely eliminate the tumor, but will often decrease the tumor’s size enough to alleviate clinical signs. Side effects of radiation include damage to the skin, as well as the risks associated with repeated anesthetic procedures.
放射治疗是一种更常用的缩小垂体肿瘤的方法。
放疗每周进行多次，持续4到6周，目的是缩小肿瘤的大小，减少临床症状。
放射治疗通常不能完全消除肿瘤，
但通常会缩小肿瘤的大小，以减轻临床症状。
辐射的副作用包括对皮肤的损伤，以及与反复麻醉过程相关的风险。
笔记📒
- 治疗
-- 放射治疗
--- 缩小肿瘤，不能完全消除肿瘤
--- 缓解症状，不能解决症状
--- 辐射副作用 - 皮肤损伤，麻醉风险
Medications can also be used to manage the hormonal effects of functional pituitary macroadenomas. While this treatment does not address the actual tumor, and the tumor will therefore continue to increase in size, medication can be used to counteract the effects of the hormones produced by these tumors. Dogs with Cushing’s disease can be treated with medications such as trilostane (Vetoryl®) to decrease cortisol production.
药物也可用于控制功能性垂体巨腺瘤的激素效应。
虽然这种治疗方法不能治疗真正的肿瘤，
因此肿瘤会继续增大，
但药物可以用来抵消这些肿瘤产生的激素的影响。
患有库兴氏病的犬可以用某些药物治疗，
如曲洛斯坦(Vetoryl®，trilostane)来减少皮质醇的产生。
笔记📒
- 治疗
-- 药物治疗
--- 不治疗肿瘤本身
--- 控制激素分泌异常的影响
----库兴氏病 - 曲洛斯坦 trilostane
END
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