Prolactinoma

Iprolactinoma sisifo esingenomdlavuza (esinobungozi) se-pituitary esivelisa i-hormone ebizwa ngokuba yi-prolactin. Oku kubangela iprolactin eninzi egazini.

Iprolactin yincindi yedlala ebangela ukuba amabele avelise ubisi (ukuncancisa).

Iprolactinoma lolona hlobo luqhelekileyo lwepituitary tumor (adenoma) evelisa ihomoni. Yenza malunga neepesenti ezingama-30 zazo zonke i-pituitary adenomas. Phantse onke amathumba e-pituitary awanomdlavuza (onobungozi). Iprolactinoma inokwenzeka njengenxalenye yemeko yelifa ebizwa ngokuba luhlobo lwe-endocrine neoplasia yohlobo 1 (MEN 1).

Iprolactinomas yenzeka kakhulu kubantu abangaphantsi kweminyaka engama-40 ubudala. Baxhaphake kakhulu kwabasetyhini kunamadoda, kodwa kunqabile ebantwaneni.

Ubuncinci isiqingatha sazo zonke iiprolactinomas zincinci (ngaphantsi kwesentimitha enye okanye 3/8 ye-intshi ububanzi). Ezi tumors zincinci zenzeka rhoqo kwabasetyhini kwaye zibizwa ngokuba zii-microprolactinomas.

Amathumba amakhulu aqhelekile emadodeni. Zivame ukwenzeka ebudaleni. Ithumba lingakhula liye kubukhulu obukhulu ngaphambi kokuba kuvele iimpawu. Izidumba ezingaphezulu kwe-3/8 intshi (1 cm) ububanzi zibizwa ngokuba zii-macroprolactinomas.

I-tumor ihlala ifunyenwe kwinqanaba langaphambili kubafazi kunamadoda ngenxa yokuhamba ngokungaqhelekanga.

Kwabasetyhini:

• Ukuhamba kobisi ngokungaqhelekanga ukusuka ebeleni kumfazi ongakhulelweyo okanye okonga (galactorrhea)
• Ukuthamba kwebele
• Ukunciphisa umdla wesondo
• Ukuncipha kombono wecala
• Intloko ebuhlungu
• Ukungachumi
• Ukuyeka ukuya exesheni akuhambelani nokuyeka ukuya exesheni, okanye ukuya exesheni okungaqhelekanga
• Umbono utshintsha

Kumadoda:

• Ukunciphisa umdla wesondo
• Ukuncipha kombono wecala
• Ukwandiswa kweethambo zebele (gynecomastia)
• Intloko ebuhlungu
• Iingxaki zokwakhiwa (ukungabi namandla)
• Ukungachumi
• Umbono utshintsha

Iimpawu ezibangelwa luxinzelelo kwi-tumor enkulu inokubandakanya:

• Intloko ebuhlungu
• Ukuhamba
• Umsele wamanzi
• Isicaphucaphu nokugabha
• Iingxaki ngengqondo yokujoja
• Iintlungu zesinus okanye uxinzelelo
• Utshintsho lombono, njengombono ophindwe kabini, iinkophe ezijingayo okanye ukulahleka kwentsimi ebonakalayo

Kungangabikho mpawu, ngakumbi emadodeni.

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho. Uya kubuzwa malunga namayeza nezinto ozithathayo.

Uvavanyo olunoku-odolwa lubandakanya:

• I-Pituitary MRI okanye i-CT scan
• Inqanaba le testosterone kumadoda
• Inqanaba leprolactin
• Uvavanyo lomsebenzi we-thyroid
• Olunye uvavanyo lomsebenzi wepituitary

Amayeza ahlala ephumelela kunyango lweprolactinoma. Abanye abantu kufuneka bathathe la mayeza ubomi babo bonke. Abanye abantu banokuyeka ukuthatha amayeza emva kweminyaka embalwa, ngakumbi ukuba ithumba labo lalincinci xa lafunyanwa okanye lanyamalala kwi-MRI. Kodwa kukho umngcipheko wokuba ithumba lingakhula kwaye livelise iprolactin kwakhona, ngakumbi ukuba ibililithumba elikhulu.

Iprolactinoma enkulu ngamanye amaxesha inokuba nkulu ngexesha lokukhulelwa.

Utyando lunokwenziwa kuyo nayiphi na kwezi zinto zilandelayo:

• Iimpawu ziqatha, njengokuvela kombono ngesiquphe
• Awunakho ukunyamezela amayeza ukunyanga ithumba
• Ithumba aliphenduli kumayeza

Imitha ihlala isetyenziswa kuphela kubantu abaneprolactinoma eqhubeka nokukhula okanye isiba mandundu emva kokuba kuvavanyo kunye notyando luzanyiwe. Imitha inokunikwa ngohlobo lwe:

• Imitha eqhelekileyo
• Imela ye-Gamma (stereosactic radiosurgery) -uhlobo lonyango lwe-radiation olujolise kwi-x-ray enamandla aphezulu kwindawo encinci kwingqondo.

Imbonakalo ihlala ilungile, kodwa ixhomekeke kwimpumelelo yonyango okanye uqhaqho. Ukuvavanywa ukujonga ukuba likhona ithumba elibuyileyo emva konyango kubalulekile.

Unyango lweprolactinoma lunokutshintsha amanqanaba ezinye iihomoni emzimbeni, ngakumbi ukuba kwenziwa utyando okanye imitha.

Amanqanaba aphezulu e-estrogen okanye i-testosterone anokubandakanyeka ekukhuleni kweprolactinoma. Abasetyhini abaneeprolactinomas kufuneka balandelwe ngokusondeleyo ngexesha lokukhulelwa. Kuya kufuneka baxoxe ngeli thumba kunye nomnikezeli wabo ngaphambi kokuba bathathe iipilisi zokulawula ukuzalwa kunye nomxholo ophakamileyo kunesiqhelo we-estrogen.

Jonga umboneleli wakho ukuba unayo nayiphi na impawu yeprolactinoma.

Ukuba ubuneprolactinoma kwixa elidlulileyo, tsalela umnikezeli wakho kulandelo ngokubanzi, okanye ukuba iimpawu zakho ziyabuya.

Adenoma - ukufihla; Prolactin - adenoma ngokufihlakeleyo yebhinqa

• Amadlala endocrine

Bronstein MD. Ukuphazamiseka kwemfihlo yeprolactin kunye neprolactinomas. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 7.

UTirosh A, Shimon I. Indlela yangoku kunyango lweprolactinomas. IMinerva Endocrinol. Ngo-2016; 41 (3): 316-323. IINKCUKACHA: 26399371 www.ncbi.nlm.nih.gov/pubmed/26399371.