Endocrine Management Of Tumours
Endocrine tumors develop in hormone-producing glands, such as the thyroid, pituitary, adrenal glands, and pancreas. These tumors may be benign or malignant and can lead to significant health issues by disrupting normal hormone balance. The endocrine management of these tumors focuses on stabilizing hormone levels, removing or shrinking tumors, and minimizing symptoms. Understanding the causes and symptoms is crucial for effective management.
Causes and Symptoms of Common Endocrine Tumors
Thyroid Tumors
- Causes: Thyroid tumors can be caused by genetic mutations, exposure to radiation, or family history of thyroid cancer. Tumors may be benign (nodules, goiters) or malignant (thyroid cancer).
- Symptoms: Swelling in the neck, hoarseness, difficulty swallowing, or breathing difficulties. Some thyroid cancers produce no symptoms in early stages, while others may cause hyperthyroidism symptoms like weight loss, nervousness, and rapid heartbeat.
- Management: Treatment may include surgery, radioactive iodine, and thyroid hormone suppression therapy to prevent cancer recurrence and stabilize thyroid function.
Pituitary Tumors
- Causes: Often due to genetic mutations or hormonal imbalances, pituitary tumors are commonly benign adenomas but can affect hormone production.
- Symptoms: Vary based on the hormone involved. For example, prolactin-secreting tumors (prolactinomas) can lead to infertility and milk production, while growth hormone-secreting tumors may cause gigantism in children or acromegaly in adults. Non-functioning tumors can cause headaches and vision issues.
- Management: Treatment options include medications (e.g., dopamine agonists for prolactinomas), surgery (transsphenoidal resection), and, if needed, radiation therapy.
Adrenal Tumors
- Causes: Adrenal tumors may develop from genetic syndromes (like MEN2 or Li-Fraumeni syndrome), or they can occur sporadically. Tumors include benign adenomas, pheochromocytomas, or malignant adrenocortical carcinomas.
- Symptoms: Symptoms depend on hormone secretion. Excess cortisol leads to Cushing’s syndrome (weight gain, high blood pressure, and diabetes), while excess aldosterone causes Conn's syndrome (hypertension, muscle weakness). Pheochromocytomas produce excess adrenaline, leading to severe headaches, sweating, and palpitations.
- Management: Treatment includes surgical resection (adrenalectomy) and hormone management with medications like mitotane for inoperable cases.
Pancreatic Neuroendocrine Tumors (PNETs)
- Causes: These tumors, often associated with genetic syndromes like MEN1, arise from hormone-producing cells of the pancreas.
- Symptoms: Dependent on the type of hormone secreted. Insulinomas cause low blood sugar (hypoglycemia), gastrinomas cause peptic ulcers, and glucagonomas lead to diabetes and skin rashes.
- Management: Management includes surgery, medications (e.g., somatostatin analogs to control hormone levels), and targeted therapies like everolimus for metastatic disease.