原文

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

Pituitary Tumors
垂體腫瘤

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

What is the pituitary gland?
什么是垂體？

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.

垂體是一個很小的器官，比豌豆還小，位于大腦的底部。

它負責產(chǎn)生影響身體許多其他器官系統(tǒng)的特殊化學物質(zhì)(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.

這些激素可以影響
腎上腺(負責產(chǎn)生應激激素)、
甲狀腺(負責產(chǎn)生甲狀腺激素)
和甲狀旁腺(負責調(diào)節(jié)鈣)，
以及胰腺和身體的其他組織。

垂體通常被稱為“主腺”，
因為它在控制內(nèi)分泌(激素)系統(tǒng)的其他部分方面很重要。

What is pituitary tumor??
什么是垂體腫瘤？

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.

垂體腫瘤是由于構(gòu)成腦下垂體的細胞的異常復制或生長而產(chǎn)生的。

腫瘤可能從
功能性的腺體組織(即產(chǎn)生激素的組織)發(fā)展而來——這些稱為功能性垂體腫瘤
——或者從垂體的非功能性部分發(fā)展而來。

大約10%的犬垂體瘤是非功能的。

What causes this cancer?
是什么引起了這種癌癥？

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.

特定寵物可能患上這種疾病或任何腫瘤或癌癥的原因并不總是明了的。

很少有腫瘤和癌癥有單一的已知病因。

大多數(shù)似乎是由一系列復雜的風險因素引起的。

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.

雖然沒有已知的飲食或環(huán)境因素導致垂體腫瘤，
但某些品種似乎好發(fā)，
包括 迷你貴賓犬、拳師犬、波士頓梗犬和臘腸犬。

雖然沒有發(fā)現(xiàn)貓和犬一樣的品種傾向，
但腫瘤往往發(fā)生在中年到老年的貓身上。

What are the signs of a pituitary tumor?
垂體腫瘤的癥狀有哪些？

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.

垂體腫瘤的癥狀取決于受影響的垂體區(qū)域。

如果腫瘤從功能性的腺體組織發(fā)展而來，
出現(xiàn)的癥狀將與這些激素的作用有關。

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，
最常見的垂體腫瘤會影響產(chǎn)生促腎上腺皮質(zhì)激素(ACTH)的區(qū)域。

過量的ACTH會導致腎上腺產(chǎn)生過多的皮質(zhì)醇(一種自然產(chǎn)生的類固醇)，
導致腎上腺皮質(zhì)亢進或庫興氏病。

庫興氏病的臨床癥狀包括食欲亢進（多食）和渴覺亢進（多飲），排尿增加（多尿）(有時導致在家里發(fā)生非預料之內(nèi)的排尿)，嗜睡，無力，喘氣，不耐熱，脫毛，肥胖和梨形腹的外觀（腹圍增大）。

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

垂體腫瘤的癥狀取決于受影響的垂體區(qū)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.

在貓中，最常見的垂體腫瘤會影響產(chǎn)生促生長素（somatotropin）或生長激素(GH)的區(qū)域。

生長激素的增加會導致肢端肥大癥（acromegaly）。

由于肢端肥大癥會導致胰島素抵抗型糖尿?。╥nsulin-resistant diabetes mellitus），
因此會出現(xiàn)渴覺亢進（多飲）、排尿增多（多尿）和食欲增加（多食）等糖尿病癥狀。

此外，過量的生長激素會導致腿、爪子、下巴、頭骨和身體其他部位的過度生長，體重增加，導致貓的外表發(fā)生變化。

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.

如果腫瘤從垂體的非功能部分發(fā)展而來，
腫塊的大小可引起一些神經(jīng)學癥狀，
如嗜睡、食欲減退、行為改變、失明、抽搐發(fā)作和步態(tài)異常。

How is this type of cancer diagnosed??
這種類型的癌癥如何診斷？

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).

如果狗狗有庫興氏病的癥狀，
你的獸醫(yī)會進行常規(guī)和專門的血液和尿液檢查。

如果檢查結(jié)果還不確定，
可能需要在3至6個月后重新測試。

然而，一旦疾病被確診，通常還要進行額外的血液檢查，
以確定病因是垂體腫瘤還是腎上腺腫瘤引起的。

同樣，
腎上腺可以用腹部X光片或超聲波進行評估，
垂體可以用更復雜的診斷成像方法進行評估，
如計算機斷層掃描(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.

如果貓咪有肢端肥大癥的癥狀，
雖然血液和尿液檢查會有所幫助，
但最確定的診斷檢查是垂體區(qū)域的CT掃描或MRI掃描。

How does this cancer typically progress?
這種癌癥的病情一般會如何發(fā)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.

由于垂體腫瘤大部分都是良性的，它們通常只在局部生長。

它們一般不會轉(zhuǎn)移(擴散到身體的其他部位)。

如果腫瘤是功能性的，而你的寵物沒有得到治療，
相關的情況將會繼續(xù)或惡化，你的寵物的健康狀態(tài)將會惡化。

如果腫瘤是無功能的，而你的寵物沒有得到治療，
隨著腫瘤的生長，神經(jīng)癥狀將繼續(xù)或惡化，或變得更難控制。

What are the treatments for this type of tumor?
這種類型的腫瘤該如何治療？

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

治療的選擇取決于垂體腫瘤是功能性的還是非功能性的。

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.

許多功能性腫瘤可以用藥物治療。

米托坦（Mitotane）和曲洛斯坦（trilostane）是兩種藥物，
已證明對患有庫興氏病的犬有效。

放射治療是另一種選擇；
一些新技術(shù)非常有效，而且?guī)缀鯖]有副作用。

在放射治療后的幾個月里，藥物治療仍然是必要的。

目前正在研究切除犬腦垂體腫瘤的手術(shù)技術(shù)，
但手術(shù)并不是一種廣泛可行的選擇（不是哪里都能做的）。

獸醫(yī)可以根據(jù)狗狗的情況為狗狗推薦最好的治療方法。

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.

通過增加胰島素劑量來控制糖尿病的臨床癥狀
是治療肢端肥大癥的貓最保守和最常見的方法。

放療可能提供了最大的成功治療機會，可以改善胰島素抵抗和神經(jīng)癥狀。

然而，腫瘤縮小的速度很慢(超過3年)，并且有損害垂體和鄰近腦組織的風險。

手術(shù)切除垂體(稱為經(jīng)蝶竇垂體切除術(shù)?transsphenoidal?hypophysectomy)是可能的，
在一些獸醫(yī)中心，它已成為主要的治療方法，
但它有很大的風險，并且需要終生補充激素來補償垂體功能的喪失。

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.

無功能垂體腫瘤最常用的治療方法是放射治療。

目標是專門針對增大的垂體，并盡可能長時間地縮小腫物的大小。

隨著技術(shù)的進步，
獸醫(yī)腫瘤學家可以在對周圍組織影響最小的情況下，
專門針對某個組織進行放射治療。

Is there anything else I should know?
我還應該了解一些什么別的事情嗎？

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.

患有庫興氏病的犬的預期發(fā)展是良好的，
保守藥物治療的平均預期壽命為2年。

至少有10%接受治療的犬能多活4年。

接受放射治療的犬可以存活2-5年。

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

“在所有病例中，早期診斷和治療往往會改善長期前景。”

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.

對于患有肢端肥大癥的貓來說，
使用各種藥物治療這些癥狀，
短期內(nèi)的預期是相當好的。

然而，由于這并沒有解決這種情況的病因，
長期預期是相對較差的。

大多數(shù)貓會死于充血性心力衰竭、慢性腎衰竭或與垂體腫瘤增大有關的癥狀。

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

在所有病例中，通過早期診斷和治療，長期預后是趨于改善的。

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

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