垂体促甲状腺激素腺瘤的诊断和治疗  

Diagnosis and treatment of thyroid-stimulating hormone pituitary adenomas

作　　者：陈东栋[1] 黄擎擎 吴建东[3] 惠国桢[1] 虞正权[1] 

机构地区：[1]苏州大学附属第一医院神经外科 [2]苏州大学附属第一医院普外科 [3]南京医科大学附属苏州医院神经外科,江苏苏州215600

出　　处：《中华神经外科疾病研究杂志》2015年第5期441-443,共3页Chinese Journal of Neurosurgical Disease Research

基　　金：国家973科研基金资助项目(2012CB518106)

摘　　要：目的探讨垂体促甲状腺激素(TSH)腺瘤所致中枢性甲亢的诊断和治疗规范。方法回顾性分析10例垂体TSH腺瘤临床资料和经鼻-蝶窦手术治疗后效果。主要症状为甲状腺肿大和中枢性甲亢症状。影像学资料显示为微腺瘤,小腺瘤,大腺瘤或巨大腺瘤。9例接受经鼻-蝶窦外科手术治疗患者中,1例术后辅以放疗,1例术后辅以药物治疗。另外1例只接受药物治疗。结果显微镜下全切6例,次全切除3例。术后病理显示均为TSH腺瘤。结论垂体TSH腺瘤需早期诊断并及早得到规范化治疗,经鼻-蝶窦手术可获得长期治疗效果。对于复发的患者可辅以放疗或是药物治疗。Objective The diagnosis and management of central hyperthyroidism due to thyroid-stimulating homone （TSH） pituitary adenomas are discussed. Methods The chnical data and treatrr^nt of thyroid-stimulating hormone pituitary adenomas were analyzed retrospectively. The main presenting symptoms were diffused goiter and central hyperthyroidism. Imaging data showed microadenomas, small, large or giant pituitary adenomas. Nine patients were treated with transsphenoidal surgery, including adjuvant radiotherapy in 1 case and adjuvant medication in 1 ease. One ease was treated with medication only. Results The results showed total removal in six cases, and partial removal in three cases. Pathological examination confirmed TSH adenomas. Conclusion Early diagnosis and standardized treatment of pituitary TSH adenorm are necessary. Effect of transsphenoidal surgery is consistent and reliable for a long term. Radiotherapy or drug therapy is suggested for the recurrent patients.

关 键 词：垂体促甲状腺激素腺瘤 甲状腺功能亢进症 经蝶窦手术 

分 类 号：R736.4[医药卫生—肿瘤]