I-craniopharyngioma iyithumba elingavamile lobuchopho. Njengoba ikhula, igcina ibangele ubuhlungu bekhanda, ukuphazamiseka okubukwayo futhi ngezinye izikhathi ukuphazamiseka okuphawulekayo kwama-hormone. Isifo esibi esake sabulala izingane nakubantu abadala, sinesimo esingcono kakhulu namuhla ngenxa yentuthuko yokuhlinzwa. Nokho, ukungenelela ngokuhlinzwa kuhlala kusinda futhi kuntekenteke … Ukwelashwa ngama-hormone kungase kudingeke ekuphileni.

Incazelo

I-Craniopharyngioma iyithumba elibi - okungukuthi, elingenawo umdlavuza - elikhula kancane elikhula endaweni ethile yobuchopho eduze ne-pituitary gland.

Ithule isikhathi eside, igcina ngokucindezela izicubu zobuchopho lapho ikhula, ibangele izimpawu ze-intracranial hypertension (ikhanda elibuhlungu, ukuphazamiseka kwamehlo).

Ngokuya ngezinga layo, lingabangela nomunye umonakalo:

• Ukungajwayelekile kombono kuyinkomba yokulimala kwenzwa ye-optic.
• Ukuphazamiseka kwe-Endocrine kuhlotshaniswa nokulimala kwe-pituitary gland, umqhubi wesistimu ye-hormonal.
• Ukuphazamiseka kwemizwa nakho kungenzeka.

Izimbangela

Ukuphindaphindeka okungalawuleki kwamangqamuzana e-embryonic asevele ekhona ku-fetus kunesibopho sokwakheka kwesimila. Asazi isizathu, kodwa siyazi ukuthi ufuzo aluhilelekile.

kwesifo

Ukuba khona kwe-craniopharyngioma kusolwa lapho ukubonakaliswa kwayo kubaluleke kakhulu ukuba kunganakwa.

• Ukuxilongwa kusekelwe ikakhulukazi ekucabangeni kwengqondo. I-MRI kanye ne-CT scans ingakwazi ukubona ngeso lengqondo indawo enembile yesimila futhi, njengomthetho, ihlukanise kwezinye izinhlobo zezimila zobuchopho.
• Ukuhlolwa kwamahomoni kwenza kube nokwenzeka ukugqamisa ngedosi elula ekushoda kwegazi ku-hormone yokukhula, amahomoni ocansi noma amahomoni egilo.
• Ukuhlolwa kokuvimbela uketshezi kusetshenziselwa ukuhlola isifo sikashukela i-insipidus. Kwenza kube nokwenzeka ukuhlola imiphumela esigulini yokungabikho ngokuphelele kwesiphuzo amahora ama-5 kuye kwayi-15. Wenziwa endaweni yesibhedlela.
• Ukuhlolwa kwe-fundus kwembula umonakalo kumthambo wamehlo.

Abantu abathintekayo

I-craniopharyngioma ivamise ukutholakala ezinganeni ezineminyaka ephakathi kwengu-5 nengu-15. Kodwa ngezinye izikhathi iqala kamuva, kube nesinye isiqongo esiphakathi kweminyaka engu-60 nengu-75.

Umuntu oyedwa kwabangama-50 angaba othintekayo. I-Craniopharyngioma imele ngaphansi kuka-5% wezimila ezinganeni ezingaphansi kweminyaka engu-14 ubudala.

I-hypertension ye-intracranial ibonakaliswa yikhanda elibuhlungu, lenyuka ngokukhwehlela noma ngokuzikhandla. Iphinde ibangele ukuhlanza kwe-jet, ngaphandle kokuthatha ukudla.

Ukuphazamiseka kweHormonal kuhlotshaniswa nokulimala kwendlala yepituitary, ekhiqiza i-hormone yokukhula namahomoni ahlukahlukene alawula ukukhishwa kwezinye izindlala ze-endocrine emzimbeni, futhi ikhiphe i-hormone elwa nomchamo ekhiqizwa ku-hypothalamus (etholakala ngenhla nje) .

• Ukuncipha kokukhula kungenxa yokushoda ekukhiqizweni kwe-hormone yokukhula. Kuwuphawu oluvamile, olukhona kumntwana oyedwa kwabathathu.
• Ukuthomba kubuye kubambezeleke ngaphezu kwengxenye yamacala.
• Ezimweni ezingu-20%, ukuntuleka kokukhiqizwa kwehomoni ye-antidiuretic kuholela ku-diabetes insipidus, okuholela ekuphumeni komchamo omningi, ukuvuka njalo ebusuku ukuyochama noma ukuchama embhedeni. Ingane (noma umuntu omdala) yomile ngaso sonke isikhathi, iphuza kakhulu, ngaphandle kwalokho iphelelwa amanzi ngokushesha.
• Ukukhuluphala, okukhona ku-10 kuya ku-25% wezingane ngesikhathi sokuxilongwa, kuxhunyaniswa nokungalingani kwamahomoni kanye / noma indlala engalawuleki ebangelwa ukucindezelwa kwesikhungo sokudla ku-hypothalamus.

Ukuphazamiseka kokubona kungaba kukhulu. Ukulimala kwe-optic nerve kubangela ukuncipha kombono kwelinye noma womabili iso (amblyopia) noma ukuncipha emkhakheni wokubona ngenxa yawo.

Ngezinye izikhathi izinkinga ze-neurological zivela:

• inkumbulo, izinkinga zokufunda nokunaka,
• ukuquleka, ukukhubazeka ohlangothini olulodwa lomzimba noma ubuso,
• ukuphazamiseka ekulawuleni izinga lokushisa lomzimba,
• izinkinga zokulala.

Ukwelapha okuhlinzwa

Intuthuko yezindlela zokuhlinza inikeze ithemba elisha emindenini ethinteke kulesi simo esake saba yingozi, ngisho noma umonakalo othile obonakalayo noma wezinzwa uhlala ungenakulungiseka. Ukungenelela kuhlose ukususa isimila (ukukhishwa) ngokushesha futhi ngokuphelele ngangokunokwenzeka.

I-craniopharyngiomas encane ingasuswa ngamakhala, kodwa ngokuvamile kuyadingeka ukuvula ugebhezi. Ukungenelela kusalokhu kunzima, nengozi yokufa ephakathi kuka-1 no-10%.

I-craniopharyngioma ingasuswa iphelele cishe izikhathi ezimbili kwezintathu. Kwezinye izimo, izinsalela ezincane zibonakala zingenakwenzeka futhi, kanye kweziyishumi, kukhishwa ingxenye kuphela yesimila.

Izinga lokuphinda livela ku-35 kuya ku-70% lapho ukunqunywa kungaphelele, kanye no-15% lapho isimila sesikhishwe ngokuphelele. 

Radiotherapy

Inganikezwa uma kwenzeka iphinda noma izinsalela zesimila, futhi ivumela u-70% weziguli ukuthi zelashwe unomphela. Ngaphandle kobuhlungu, izikhathi zokukhipha imisebe zihlala cishe imizuzu eyishumi nanhlanu.

I-Gamma knife (radiochirurgie)

I-Gamma Knife radiosurgery isebenzisa imisebe ye-gamma enamandla kakhulu ukuze ibhubhise izimila ezincane ngokukhipha imisebe eyodwa. 

Ukwelashwa ngama-hormone

I-pituitary gland ivamise ukulimala unomphela ngemva kokuhlinzwa. Ama-hormone ashintshwayo anikezwa ukunxephezela ukushoda kwama-hormone, nsuku zonke futhi kaningi impilo yonke:

• I-hormone yokukhula inqunyelwe izingane eziyekile ukukhula, ngezinye izikhathi nakubantu abadala ngenxa yendima yayo ku-metabolism.
• Amahomoni ocansi avumela ukuthomba kanye nomsebenzi wocansi ojwayelekile. Imijovo ye-gonadotropin ingase inikezwe ukwelapha izinkinga zokuzala.
• Amahomoni egilo adlala indima ebalulekile kumetabolism kanye nasekuthuthukisweni kwamathambo nesimiso sezinzwa.
• I-Desmopressin yelapha isifo sikashukela i-insipidus.
• I-Glucocorticoids ibalulekile ekulawuleni ukucindezeleka kanye ne-metabolism.

Ukwesekwa kwesiguli

Imfundo yokwelapha

Kuyadingeka ukuphatha kahle ukwelashwa kwe-hormone.

Ukwesekwa ngokwengqondo

Kuyasiza ukubhekana nokumenyezelwa kokuxilongwa, ukuhlinzwa, ubungozi bokuphindela emuva noma izithiyo zokwelashwa kwe-hormonal.

Isifiso sokudla esingenakuvinjelwa (ukudla ngokweqile) siwumphumela ovamile wokuhlinzwa, okuxhunyaniswa nokulimala ku-hypothalamus. Ukudla okunganqamukiyo noma ukucindezelwa kokudla kubonakala kucishe kungenzeki ukukulawula, okuholela ekukhuleni kwesisindo ngezinye izikhathi okuphawulekayo nasezinkingeni ezingokwengqondo. Ukubonana nochwepheshe bezinkinga zokudla kungaba usizo.

Ukunakekelwa okukhethekile

Ngemva kokuhlinzwa, ukukhubazeka okuthile kudinga ukulandelelwa okukhethekile.

• Kufika ku-30% weziguli ezinokukhubazeka kokubona.
• Izinkinga zenkumbulo nazo zivamile.