Disadvantages of surgical

Disadvantages of surgical treatment are bound to possibility on occasion lethal outcomes and development of operational complications, mainly damages of a frontal lobe and a leg of a pituitary body, a hemorrhage to a pituitary body, an infection and especially at transsphenoidal access - rhinorrheas . Radial therapy, on the other hand, allows to avoid the acute complications bound to surgical operation, and is much easier transferred by the patient. Its disadvantages concern: 1 - absence of effect at some patients with radio medrol dose pack refractory tumours (some radiotherapists insist on necessity of the histological diagnosis prior to the beginning of treatment); 2 - the slow reaction interfaced to danger of an acute swelling of a tumour; 3 - development sometimes pituitary body apoplexies; 4 - in very rare cases damage of a surrounding nervous tissue; 5 - the remote prospect of development of a hypopituitarism owing to an irradiation of a healthy tissue . The probability of development of a syndrome of an "empty" Turkish saddle with visual disturbances owing to an optic nerve decussation at surgical and radial treatment is identical. At a choice of a method of treatment it is necessary to be guided basically by such criteria, as the remote results concerning conservation and-or sight restoration, conservation of endocrine function and frequency of relapses.
Though at the description of results of treatment of the majority of patients did not do difference between functioning and nonfunctioning tumours of a pituitary body, but frequency of relapses after surgical and radial treatment, apparently, is almost identical [147, 153, 154]. Encourages that fact, that frequency of relapses at both kinds of treatment last years more low, than 10-20 years ago. It is important to note, however, that diagnostic criteria, methods of treatment and inspection of patients after it sharply differ in different clinics, and groups of patients therefore in many respects appear incomparable. Nevertheless without excessively large tumours of a pituitary body the forecast concerning a softening of visual symptoms and relapses, apparently, is rather favorable for the majority of patients. Relative frequency of development of a hypopituitarism after operation and an irradiation also is approximately identical, anafranil though there are differences in terms of occurrence of this complication. The hypopituitarism after surgical treatment develops at once, and after radial therapy usually in some years. Though some depression of function of a pituitary body observed after operation almost at 1/3 patients, but according to later data, frequency of this complication has decreased approximately to 15 , i.e. To level, comparable with that at radial therapy. Application of an irradiation as a primary method of treatment at nonfunctioning tumours of a pituitary body does not interfere with the subsequent operation in case of relapse, primary operation also does not interfere with the subsequent irradiation. Proceeding from results of the treatment spent several decades ago, it is considered to be, that for preventive maintenance of relapses of the nonfunctioning tumours which frequency at patients in some groups reaches 15-20 [147], radial therapy is more preferable for using as addition to surgical treatment. Though perfection of receptions of treatment has reduced now necessity for the combined therapy, but it still recommend [126, 147]. THE TUMOURS OF THE PITUITARY BODY ACCOMPANIED BY THE HYPERSECRETION OF HORMONES By means of radio immunologic definition of hormones in blood it is possible to show, that pituitary body tumours in the majority are hyperfunctioning though at some patients rising of level of hormones can and not be accompanied by any clinical symptoms, and is only biochemical marker of a tumour. Tumours cosecrete (as decreasing frequency) Prolactinum, , , and . Though usually each tumour consists of cells of one type and there is superfluous production of one hormone, but quite often observe also a combination of hypersecretion or with Prolactinum hypersecretion. At hyperfunctioning tumours of a pituitary body often simultaneously there are tumours of islets of a pancreas, carcinoid tumours and tumours of parathyroid glands that forms a syndrome of a plural endocrine neoplasia (I type). Treatment principles pituitary body tumours differ from those at nonfunctioning tumours meaning that treatment, sufficient for a tumour stunt, can not lead to inhibition of hormonal secretion. Besides, as an alternative method of treatment the therapy referred on a hypersecretion of a hormone is possible also medicinal (). In this section features tumours are stated and differences of their treatment in comparison with nonfunctioning tumours are underlined.