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| U tuyen tung la gi? Nguyen nhan, trieu chung, muc do nguy hiem va phuong phap dieu tri
U tuyen tung (Pineal Region Tumor) la khoi u xuat hien tai tuyen tung hoac khu vuc xung quanh tuyen tung trong nao. Day la nhom khoi u tuong doi hiem gap, co the xuat hien o ca tre em va nguoi truong thanh. Tuy theo loai mo hoc, u tuyen tung co the phat trien cham, tuong doi lanh tinh hoac mang tinh chat ac tinh cao.
Tuyen tung nam sau trong nao, gan nao that ba va cac cau truc lien quan den luu thong dich nao tuy. Vi vay, ngay ca mot khoi u co kich thuoc khong qua lon cung co the gay tac nghen dong chay dich nao tuy, dan den nao ung thuy, tang ap luc noi so va nhieu trieu chung than kinh nghiem trong.
Nhung bieu hien thuong gap cua u vung tuyen tung bao gom dau dau, buon non, non, nhin doi, kho nhin len tren, mat thang bang va roi loan y thuc. Mot so loai u con co the lien quan den roi loan noi tiet hoac day thi som.
Vay u tuyen tung la gi, co phai ung thu nao khong, co chua khoi duoc khong va phuong phap dieu tri nao duoc ap dung? Bai viet duoi day cua Benh Vien Thien Hanh (https://thienhanhhospital.com/) se giup ban hieu ro nguyen nhan, phan loai, trieu chung, chan doan, dieu tri va tien luong cua benh.
U tuyen tung la gi?
U tuyen tung la thuat ngu thuong duoc su dung de mo ta cac khoi u phat sinh tu tuyen tung hoac xuat hien tai vung tuyen tung.
Tuy nhien, ve mat y hoc, can phan biet u nhu mo tuyen tung voi cac loai u khac nam o vung tuyen tung.
U nhu mo tuyen tung phat sinh tu nhung te bao thuoc nhu mo tuyen tung.
Trong khi do, vung tuyen tung con co the xuat hien u te bao mam, u than kinh dem, u mang nao va mot so loai ton thuong khac.
Nhung khoi u nay co the co hinh anh tuong tu nhau tren MRI nhung phuong phap dieu tri va tien luong rat khac nhau.
Do do, viec xac dinh chinh xac loai u dong vai tro quan trong trong lua chon phuong phap dieu tri.
Cac loai u tuyen tung thuong gap
U vung tuyen tung duoc chia thanh nhieu nhom dua tren nguon goc te bao va dac diem mo benh hoc.
1. U te bao tuyen tung – Pineocytoma
Pineocytoma la khoi u phat sinh tu nhu mo tuyen tung, thuong duoc xep do 1 theo WHO.
Day la loai u co xu huong phat trien cham va thuong gap o nguoi truong thanh.
Trieu chung co the xuat hien khi khoi u du lon de chen ep cac cau truc xung quanh.
Neu co the phau thuat cat bo hoan toan, tien luong cua nhieu benh nhan tuong doi thuan loi.
Tuy nhien, viec phau thuat co the gap kho khan do vi tri sau va gan nhung mach mau quan trong.
2. U nguyen bao tuyen tung – Pineoblastoma
Pineoblastoma la loai u nhu mo tuyen tung ac tinh cao, duoc xep do 4 theo WHO.
Khoi u co the phat trien nhanh va thuong gap o tre em hon so voi nguoi truong thanh.
Pineoblastoma co kha nang lan theo dich nao tuy den nhung vi tri khac trong he than kinh trung uong.
Viec dieu tri thuong can phoi hop nhieu phuong phap nhu phau thuat, hoa tri va xa tri tuy tuoi, tinh trang benh va muc do lan rong.
3. U nhu mo tuyen tung biet hoa trung gian
Pineal Parenchymal Tumor of Intermediate Differentiation, viet tat la PPTID, la loai u co dac diem sinh hoc nam giua pineocytoma va pineoblastoma.
Loai u nay thuong duoc phan do 2 hoac 3 theo WHO.
Muc do phat trien, kha nang tai phat va tien luong co the khac nhau giua cac benh nhan.
Dieu tri co the bao gom phau thuat, xa tri hoac nhung phuong phap khac tuy truong hop.
4. U te bao mam vung tuyen tung
U te bao mam (Germ Cell Tumor) la mot trong nhung nhom u quan trong tai vung tuyen tung, dac biet o tre em va thanh thieu nien.
Nhom nay bao gom germinoma va cac loai u te bao mam khong phai germinoma.
Germinoma thuong nhay voi xa tri va hoa tri, vi vay nhieu truong hop co tien luong tot khi duoc dieu tri dung phac do.
Cac loai u te bao mam khac co the co dac diem sinh hoc va muc do nguy hiem khac nhau.
5. U than kinh dem vung tuyen tung
U than kinh dem co the xuat hien tai nhung cau truc than kinh xung quanh tuyen tung.
Muc do ac tinh phu thuoc vao loai u, phan do va dac diem phan tu.
Nguyen nhan gay u tuyen tung
Hien nay, nguyen nhan chinh xac cua phan lon cac truong hop u tuyen tung van chua duoc xac dinh.
Khoi u co the hinh thanh khi te bao xuat hien nhung bien doi di truyen hoac phan tu lam roi loan qua trinh phat trien va phan chia.
Mot so yeu to duoc nghien cuu bao gom:
Bien doi di truyen
Mot so loai u tuyen tung co nhung bat thuong phan tu dac trung.
Vi du, mot so truong hop pineoblastoma co lien quan den cac bat thuong trong nhung con duong dieu hoa RNA va kiem soat tang sinh te bao.
Tuy nhien, khong phai tat ca truong hop deu co yeu to di truyen tu cha me.
Hoi chung di truyen
Mot so hoi chung di truyen hiem gap co the lam tang nguy co xuat hien cac loai u lien quan den vung tuyen tung.
Vi du, nguoi mac u nguyen bao vong mac di truyen co the co nguy co phat trien pineoblastoma trong mot hoi chung duoc goi la u nguyen bao vong mac ba ben.
Tuoi tac
Mot so loai u vung tuyen tung thuong gap hon o tre em va thanh thieu nien, trong khi nhung loai khac xuat hien o nguoi truong thanh.
Yeu to moi truong
Hien chua co bang chung chac chan cho thay mot thoi quen sinh hoat cu the truc tiep gay ra u tuyen tung.
Khong nen ket luan rang mat ngu, cang thang hoac su dung dien thoai la nguyen nhan gay benh.
Trieu chung u tuyen tung thuong gap
Trieu chung u tuyen tung chu yeu lien quan den tinh trang chen ep cac cau truc nao xung quanh, tac nghen luu thong dich nao tuy va anh huong den nhung duong dan truyen than kinh.
Dau dau
Dau dau la mot trong nhung trieu chung thuong gap.
Nguoi benh co the dau am i, keo dai hoac tang dan.
Trong mot so truong hop, dau dau lien quan den tang ap luc noi so do nao ung thuy.
Buon non va non
Khi khoi u gay tac nghen dong chay dich nao tuy, ap luc trong he thong nao that co the tang.
Nguoi benh co the xuat hien buon non va non, dac biet khi tinh trang tang ap luc noi so tien trien.
Nhin doi
Khoi u vung tuyen tung co the anh huong den nhung cau truc dieu khien van dong mat.
Nguoi benh co the nhin thay hai hinh anh cua cung mot vat.
Kho nhin len tren
Day la mot dau hieu dac trung cua ton thuong vung mai trung nao.
Nguoi benh co the gap kho khan khi di chuyen mat len phia tren.
Roi loan van dong mat
Mot so benh nhan co the xuat hien nhung bat thuong ve phan xa dong tu, kha nang hoi tu hoac phoi hop van dong mat.
Mat thang bang
Khoi u co the anh huong den cac cau truc than kinh lien quan den phoi hop van dong.
Nguoi benh co the di loang choang hoac kho giu thang bang.
Chong mat
Mot so benh nhan co the cam thay choang vang hoac mat on dinh khi di chuyen.
Buon ngu bat thuong
Tang ap luc noi so hoac ton thuong cac cau truc than kinh co the gay buon ngu, lo mo.
Thay doi y thuc
Trong truong hop nao ung thuy cap hoac tang ap luc noi so nghiem trong, nguoi benh co the bi roi loan y thuc.
Day la dau hieu can duoc cap cuu.
Chan doan u tuyen tung nhu the nao?
Chan doan u tuyen tung can ket hop tham kham than kinh, chan doan hinh anh va nhung xet nghiem chuyen sau khi can thiet.
Kham than kinh
Bac si danh gia y thuc, van dong mat, dong tu, thi giac, thang bang va nhung chuc nang than kinh khac.
Chup MRI nao
MRI nao co tiem thuoc tuong phan tu khi phu hop la phuong phap quan trong trong danh gia khoi u vung tuyen tung.
MRI giup xac dinh vi tri, kich thuoc, dac diem khoi u va muc do anh huong den nhung cau truc xung quanh.
Bac si cung co the danh gia tinh trang gian nao that va dau hieu tac nghen luu thong dich nao tuy.
Chup CT so nao
CT co the giup phat hien voi hoa, xuat huyet hoac nao ung thuy.
Phuong phap nay dac biet huu ich trong mot so tinh huong cap cuu.
MRI nao va tuy song
Neu nghi ngo loai u co kha nang lan theo dich nao tuy, bac si co the chi dinh MRI toan bo truc than kinh.
Xet nghiem dau an khoi u
Mot so u te bao mam co the lam tang cac dau an nhu AFP hoac beta-hCG trong mau hoac dich nao tuy.
Ket qua xet nghiem co the ho tro dinh huong chan doan va lua chon phuong phap dieu tri.
Tuy nhien, khong phai moi u te bao mam deu co dau an tang.
Xet nghiem dich nao tuy
Trong mot so truong hop, bac si co the chi dinh xet nghiem dich nao tuy de danh gia dau an khoi u hoac te bao bat thuong.
Tuy nhien, khong duoc choc do dich nao tuy khi co nguy co thoat vi nao do tang ap luc noi so hoac tac nghen dich nao tuy chua duoc xu tri phu hop.
Viec lay dich nao tuy can duoc bac si chuyen khoa danh gia an toan truoc khi thuc hien.
Sinh thiet khoi u
Sinh thiet giup lay mo de xac dinh loai u.
Mot so truong hop co the duoc sinh thiet noi soi hoac bang ky thuat dinh vi phu hop.
Giai phau benh
Mau mo duoc phan tich de xac dinh loai u va dac diem mo hoc.
Trong nhung truong hop can thiet, xet nghiem phan tu co the duoc thuc hien de ho tro phan loai.
Tham kham cac trieu chung nghi ngo u tuyen tung tai Buon Ma Thuot
Doi voi nguoi dan tai Dak Lak va khu vuc Tay Nguyen, Benh vien Da khoa Thien Hanh tai Buon Ma Thuot la mot co so y te co the lien he de duoc huong dan tham kham khi xuat hien nhung trieu chung than kinh bat thuong.
Cac bieu hien nhu dau dau keo dai tang dan, buon non, non, nhin doi, kho nhin len tren hoac mat thang bang can duoc danh gia de xac dinh nguyen nhan.
Trong qua trinh tham kham, bac si co the khai thac benh su, kiem tra chuc nang than kinh va can nhac nhung phuong phap chan doan hinh anh phu hop.
Nguoi benh co the lien he truc tiep Khoa noi tong hop - Benh Vien Da Khoa Thien Hanh de xac nhan cac dich vu kham chuyen khoa, chan doan hinh anh va kha nang tiep nhan hien co.
Neu phat hien khoi u vung tuyen tung, nguoi benh can duoc danh gia tai co so co chuyen mon ve ngoai than kinh, ung buou than kinh va cac phuong phap dieu tri lien quan.
Dac biet, truong hop u tuyen tung gay nao ung thuy hoac tang ap luc noi so can duoc xu tri kip thoi.
Neu xuat hien dau dau du doi, non lien tuc, lo mo, kho danh thuc hoac roi loan y thuc, can goi cap cuu 115 hoac den co so cap cuu phu hop ngay lap tuc.
Cau hoi thuong gap ve u tuyen tung
U tuyen tung la gi?
U tuyen tung la khoi u xuat hien tai tuyen tung hoac vung xung quanh tuyen tung trong nao.
U tuyen tung tieng Anh la gi?
Ten tieng Anh thuong dung la Pineal Region Tumor. Nhung khoi u phat sinh tu nhu mo tuyen tung duoc goi la Pineal Parenchymal Tumors.
U tuyen tung co phai ung thu khong?
Mot so loai u lanh tinh hoac co do ac tinh thap, trong khi nhung loai khac co tinh chat ac tinh cao.
U tuyen tung co nguy hiem khong?
Co the. Khoi u co the gay nao ung thuy, tang ap luc noi so, roi loan thi giac va nhung bien chung than kinh khac.
U tuyen tung co chua khoi duoc khong?
Mot so loai u co the dat ket qua dieu tri rat tot, nhung tien luong phu thuoc vao loai mo hoc va muc do benh.
U tuyen tung song duoc bao lau?
Thoi gian song thay doi dang ke giua cac loai u, tuoi va dap ung dieu tri.
Ket luan
U tuyen tung la nhom khoi u xuat hien tai tuyen tung hoac khu vuc xung quanh tuyen tung trong nao, bao gom nhieu loai co dac diem sinh hoc va muc do ac tinh khac nhau. Mot so khoi u phat trien cham va co tien luong tuong doi tot, trong khi nhung loai khac co the tien trien nhanh hoac lan rong trong he than kinh trung uong.
Do vi tri gan cong nao va vung mai trung nao, u tuyen tung co the gay nao ung thuy, tang ap luc noi so, dau dau, non, nhin doi va roi loan van dong mat.
Chan doan thuong dua tren MRI, danh gia dau an khoi u va xet nghiem mo benh hoc khi can thiet. Phuong phap dieu tri co the bao gom phau thuat, xa tri, hoa tri hoac xu tri nao ung thuy.
Nguoi dan tai Buon Ma Thuot va khu vuc Tay Nguyen co the lien he Benh Vien Thien Hanh Dak Lak de duoc huong dan tham kham cac trieu chung than kinh bat thuong va xac dinh phuong an danh gia chuyen sau phu hop. |
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