{"id":501,"date":"2025-04-03T08:17:53","date_gmt":"2025-04-03T08:17:53","guid":{"rendered":"https:\/\/neurosurgicalsociety.lu\/?p=501"},"modified":"2025-04-03T08:27:29","modified_gmt":"2025-04-03T08:27:29","slug":"pituitary-neuroendocrine-tumor-pitnet","status":"publish","type":"post","link":"https:\/\/neurosurgicalsociety.lu\/fr\/pituitary-neuroendocrine-tumor-pitnet\/","title":{"rendered":"Tumeur (Neuroendocrine) Hypophysaire (PitNET)"},"content":{"rendered":"

[vc_section full_width=\u00a0\u00bbstretch_row\u00a0\u00bb min_height=\u00a0\u00bb289″ css=\u00a0\u00bb.vc_custom_1734115520928{background-image: url(https:\/\/neurosurgicalsociety.lu\/wp-content\/uploads\/2024\/12\/Mask-Group-5.jpg?id=2) !important;}\u00a0\u00bb][vc_row][vc_column][\/vc_column][\/vc_row][\/vc_section][vc_section full_width=\u00a0\u00bbstretch_row\u00a0\u00bb content_placement=\u00a0\u00bbmiddle\u00a0\u00bb][vc_row full_width=\u00a0\u00bbstretch_row_content_no_spaces\u00a0\u00bb content_placement=\u00a0\u00bbmiddle\u00a0\u00bb][vc_column width=\u00a0\u00bb1\/2″ css=\u00a0\u00bb.vc_custom_1734116648319{background-color: #2B8899 !important;}\u00a0\u00bb el_class=\u00a0\u00bbmax-half-width\u00a0\u00bb][vc_column_text css=\u00a0\u00bb\u00a0\u00bb]<\/p>\n

Tumeur (Neuroendocrine) Hypophysaire (PitNET)<\/h1>\n

[\/vc_column_text][\/vc_column][vc_column width=\u00a0\u00bb1\/2″][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row css=\u00a0\u00bb.vc_custom_1734117085525{margin-top: 100px !important;margin-bottom: 50px !important;}\u00a0\u00bb][vc_column][vc_column_text css=\u00a0\u00bb\u00a0\u00bb]Une\u00a0Tumeur Neuroendocrine Hypophysaire (PitNET)<\/strong>, anciennement appel\u00e9e\u00a0ad\u00e9nome hypophysaire<\/strong>, est une tumeur d\u00e9velopp\u00e9e \u00e0 partir de l\u2019hypophyse, une petite glande endocrine situ\u00e9e \u00e0 la base du cr\u00e2ne. Ces tumeurs se classent en deux types principaux :\u00a0les <\/strong>PitNETs fonctionnels<\/strong>,<\/strong> qui produisent un exc\u00e8s d\u2019hormones (ex. hormone de croissance, prolactine, ACTH), et\u00a0les PitNETs non fonctionnels<\/strong>,<\/strong> qui ne s\u00e9cr\u00e8tent pas d\u2019hormones mais peuvent provoquer des sympt\u00f4mes par compression des structures avoisinantes.<\/p>\n

Synonymes : Ad\u00e9nome hypophysaire<\/strong>\u00a0<\/strong>(terme historique), Tumeur hypophysaire, Tumeur neuroendocrine de l\u2019hypophyse<\/strong><\/h4>\n

Traitement chirurgical : R\u00e9section endoscopique transsph\u00e9no\u00efdale<\/strong><\/h3>\n

Le traitement standard des PitNETs est la\u00a0chirurgie endoscopique transsph\u00e9no\u00efdale<\/strong>, <\/strong>o\u00f9 la tumeur est retir\u00e9e\u00a0<\/strong>par le nez (voie transsph\u00e9no\u00efdale)<\/strong>\u00a0sans incision externe. Cette technique permet un acc\u00e8s\u00a0mini-invasif<\/strong>\u00a0\u00e0 l\u2019hypophyse via le sinus sph\u00e9no\u00efdal,\u00a0sans cicatrice visible sur la t\u00eate<\/strong>.<\/strong> L\u2019intervention est g\u00e9n\u00e9ralement r\u00e9alis\u00e9e avec une\u00a0approche endoscopique endonasale<\/strong>, parfois assist\u00e9e par la neuronavigation et l\u2019imagerie perop\u00e9ratoire.<\/p>\n

Selon la taille et l\u2019extension de la tumeur, une\u00a0greffe de tissu adipeux<\/strong>\u00a0pr\u00e9lev\u00e9e sur\u00a0l<\/strong>\u2019abdomen ou la cuisse<\/strong>\u00a0<\/strong>peut \u00eatre n\u00e9cessaire pour combler la cavit\u00e9 op\u00e9ratoire et r\u00e9duire le risque de\u00a0fistule du LCR<\/strong>\u00a0(fuite du liquide c\u00e9phalo-rachidien).<\/p>\n

R\u00e9cup\u00e9ration et surveillance post-op\u00e9ratoire<\/strong><\/h3>\n

Les patients passent g\u00e9n\u00e9ralement les\u00a024 \u00e0 48 premi\u00e8res heures<\/strong>\u00a0en\u00a0<\/strong>unit\u00e9 de soins interm\u00e9diaires ou en soins intensifs<\/strong>,<\/strong> selon l\u2019\u00e9volution post-op\u00e9ratoire. Une surveillance rapproch\u00e9e est essentielle pour d\u00e9tecter d\u2019\u00e9ventuelles complications :<\/p>\n

1. \u00c9quilibre hydrique et \u00e9lectrolytique<\/strong><\/h4>\n
    \n
  • Diab\u00e8te insipide (DI)<\/strong>\u00a0: Un d\u00e9ficit en hormone antidiur\u00e9tique (ADH) entra\u00eenant une polyurie excessive et une d\u00e9shydratation.<\/li>\n
  • SIADH (s\u00e9cr\u00e9tion inappropri\u00e9e d\u2019ADH)<\/strong>\u00a0: Peut provoquer une\u00a0hyponatr\u00e9mie<\/strong>\u00a0<\/strong>n\u00e9cessitant une gestion stricte des apports hydriques.<\/li>\n<\/ul>\n

    2. Fistule du LCR & cicatrisation<\/strong><\/h4>\n
      \n
    • Une\u00a0fuite du LCR<\/strong>\u00a0peut n\u00e9cessiter un\u00a0repos strict, un drainage lombaire ou une r\u00e9intervention<\/strong>.<\/strong><\/li>\n
    • En cas de\u00a0greffe graisseuse<\/strong>, une\u00a0petite cicatrice<\/strong>\u00a0sera pr\u00e9sente sur\u00a0l\u2019abdomen ou la cuisse<\/strong>.<\/strong><\/li>\n<\/ul>\n

      3. Suivi ophtalmologique<\/strong><\/h4>\n
        \n
      • Si la tumeur comprimait le\u00a0chiasma optique<\/strong>\u00a0ou les\u00a0nerfs optiques<\/strong>, provoquant des troubles visuels (ex.\u00a0h\u00e9mianopsie bitemporale, baisse d\u2019acuit\u00e9 visuelle, troubles des couleurs<\/strong>), un\u00a0suivi post-op\u00e9ratoire avec un ophtalmologue<\/strong>\u00a0est recommand\u00e9.<\/li>\n
      • Un bilan visuel comprenant un\u00a0examen du champ visuel<\/strong>\u00a0est g\u00e9n\u00e9ralement pr\u00e9vu\u00a03 mois apr\u00e8s l\u2019op\u00e9ration<\/strong>.<\/strong><\/li>\n<\/ul>\n

        4. Imagerie et suivi \u00e0 long terme<\/strong><\/h4>\n
          \n
        • Une\u00a0IRM post-op\u00e9ratoire<\/strong>\u00a0<\/strong>est r\u00e9alis\u00e9e\u00a0vers 3 mois<\/strong>\u00a0pour \u00e9valuer l\u2019\u00e9volution.<\/li>\n
        • Un suivi endocrinologique est indispensable en raison du risque d\u2019insuffisance hormonale<\/strong>\u00a0<\/strong>n\u00e9cessitant un traitement substitutif.<\/li>\n<\/ul>\n

          La\u00a0voie transsph\u00e9no\u00efdale endoscopique<\/strong>\u00a0a r\u00e9volutionn\u00e9 la chirurgie hypophysaire, permettant\u00a0une r\u00e9cup\u00e9ration plus rapide, moins de complications et aucune cicatrice externe<\/strong>,<\/strong> tout en n\u00e9cessitant un suivi rigoureux.[\/vc_column_text][vc_row_inner][vc_column_inner width=\u00a0\u00bb1\/4″][\/vc_column_inner][vc_column_inner width=\u00a0\u00bb1\/2″][vc_column_text css=\u00a0\u00bb\u00a0\u00bb]

          Avertissement :<\/b><\/b><\/h3>\n

          Les informations ci-dessus sont fournies \u00e0 titre indicatif et ne remplacent pas une consultation individualis\u00e9e avec un professionnel de sant\u00e9 qualifi\u00e9. La Soci\u00e9t\u00e9 Luxembourgeoise de Neurochirurgie et de Chirurgie du Rachis a.s.b.l. (SLNCR) ne peut \u00eatre tenue responsable de l\u2019exactitude, de l\u2019exhaustivit\u00e9 ou de l\u2019applicabilit\u00e9 de ces informations \u00e0 des cas sp\u00e9cifiques, ni des r\u00e9sultats chirurgicaux, des approches sp\u00e9cifiques des chirurgiens, ou des complications potentielles d\u00e9coulant de l\u2019intervention. Les patients sont invit\u00e9s \u00e0 discuter des d\u00e9tails de leur condition, des options de traitement et des risques potentiels directement avec leur chirurgien.[\/vc_column_text][\/vc_column][\/vc_row][\/vc_section]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

          Pituitary Neuroendocrine Tumor (PitNET)<\/p>\n","protected":false},"author":1,"featured_media":504,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[24],"tags":[],"class_list":["post-501","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-surgery-fr"],"yoast_head":"\nTumeur (Neuroendocrine) Hypophysaire (PitNET) - neurosurgicalsociety<\/title>\n<meta name=\"description\" content=\"Tumeur (Neuroendocrine) Hypophysaire (PitNET)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/neurosurgicalsociety.lu\/fr\/pituitary-neuroendocrine-tumor-pitnet\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tumeur (Neuroendocrine) Hypophysaire (PitNET) - neurosurgicalsociety\" \/>\n<meta property=\"og:description\" content=\"Tumeur (Neuroendocrine) Hypophysaire (PitNET)\" \/>\n<meta property=\"og:url\" content=\"https:\/\/neurosurgicalsociety.lu\/fr\/pituitary-neuroendocrine-tumor-pitnet\/\" \/>\n<meta property=\"og:site_name\" content=\"neurosurgicalsociety\" \/>\n<meta property=\"article:published_time\" content=\"2025-04-03T08:17:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-04-03T08:27:29+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/neurosurgicalsociety.lu\/wp-content\/uploads\/2025\/04\/PitNET.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"604\" \/>\n\t<meta property=\"og:image:height\" content=\"340\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"NeurOSurgicaL_WP_Admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"NeurOSurgicaL_WP_Admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/neurosurgicalsociety.lu\/fr\/pituitary-neuroendocrine-tumor-pitnet\/\",\"url\":\"https:\/\/neurosurgicalsociety.lu\/fr\/pituitary-neuroendocrine-tumor-pitnet\/\",\"name\":\"Tumeur (Neuroendocrine) Hypophysaire (PitNET) - 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