促甲状腺激素型垂体肿瘤的诊断及治疗策略  

Diagnosis and treatment of thyroid-stimulating hormone secreting pituitary adenoma

作　　者：韩松[1] 王鹏斐[1] 杨亚坤[1] 刘宁[1] 于春江[1] 闫长祥[1] Hart Song;Wang Pengfei;Yang Yakun;Liu Ning;Yu Chunjiang;Yan Changxiang(Department ofNeurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China)

机构地区：[1]首都医科大学三博脑科医院神经外科,北京100093

出　　处：《中国微侵袭神经外科杂志》2018年第2期59-62,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家科技支撑计划(编号:2014BAI04B01)

摘　　要：目的总结促甲状腺激素型(TSH型)垂体腺瘤的临床表现与诊治经验。方法回顾性分析9例TSH型垂体腺瘤病例资料。9例病人均经手术治疗,其中开颅手术4例,经蝶手术5例。结果全切除4例,近全切除1例,大部分切除4例。在7例术前TSH增高病例中,术后降至正常5例。术后并发症:电解质紊乱2例,脑脊液鼻漏1例,术区出血1例。术后随访35~78个月,经影像学及激素水平综合评估,治愈4例。结论 TSH型垂体腺瘤存在侵袭生长,质地偏韧的特性,治疗策略需要根据病人实际情况,个性化选择治疗方案。Objective To summarize the clinical manifestation, diagnosis and treatment of thyroid-stimulating hormone（TSH）-secreting pituitary adenoma. Methods The clinical data of 9 patients with TSH-secreting pituitary adenoma were analyzed retrospectively. Nine patients were treated by surgery, including craniotomy in 4, transsphenoidal surgery in 5. Results The tumor was totally resected in 4 cases, subtotally in 1 and partially in 4. There were 7 patients with high TSH level preoperatively and 5 returned to normal of TSH level after operation. The postoperative complications included electrolyte disorder in 2 cases, cerebrospinal rhinorrhea in 1 and intraoperative hemorrhage in 1. The patients were followed up from 35-78 months. The cure was in 4 cases after imaging and hormone level assessment. Conclusions TSH-secreting pituitary adenomas have the characteristics of invasive growth and rigid texture. The treatment strategy needs to be individualized according to the actual situation of the patients.

关 键 词：垂体肿瘤 促甲状腺激素 甲状腺功能亢进 

分 类 号：R736.4[医药卫生—肿瘤]