被误诊为垂体瘤并手术的原发性甲状腺功能减退症  

Primary hypothyroidism misdiagnosed as pituitary tumor to be operated on

作　　者：李桂梅 马雪 张书乐 王增敏 LI Gui-mei;MA Xue;ZHANG Shu-le(Department of Pediatric Endocrinology,Provincial Hospital affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院儿科内分泌综合科,山东济南250021

出　　处：《中国实用儿科杂志》2020年第7期536-539,共4页Chinese Journal of Practical Pediatrics

摘　　要：磁共振成像示鞍区肿块或垂体占位性病变常见于颅咽管瘤、颅内生殖细胞瘤、垂体瘤、垂体病理性增生。颅咽管瘤、生殖细胞瘤影像学易与垂体病理性增生鉴别,而垂体瘤与原发性甲状腺功能减退症导致的垂体病理性增生影像学上很难区别,且二者治疗方法截然不同。前者一般需手术治疗,后者只需口服甲状腺素便可使垂体恢复正常,但如果将其误诊为垂体瘤行手术,后果严重。文章通过复习国内外文献,阐述如何通过临床表现、实验室检查及治疗性磁共振反应来清晰地诊断和鉴别诊断鞍区肿块。避免将原发性甲状腺功能减退症误诊成垂体瘤手术。MRI shows that sellar mass or pituitary space occupying lesions are common in patients with craniopharyngioma,intracranial germ cell tumor,pituitary adenoma and pituitary pathological hyperplasia.The imaging of craniopharyngioma and germinoma is easy to differentiate from the pituitary pathological hyperplasia.However,it is difficult to distinguish pituitary tumor from pituitary pathological hyperplasia caused by primary hypothyroidism on imaging,and the treatment methods of them are quite different.The former usually needs surgical treatment,while for the latter only oral thyroxine is needed to make the pituitary return to normal.But if the latter is misdiagnosed as pituitary tumor and is operated on,the consequences will be serious.In this paper,we will elaborate how to diagnose and differentiate sellar mass clearly through clinical manifestations,laboratory examination and therapeutic MR response by review of literature,so that it can be avoided to misdiagnose primary hypothyroidism as pituitary adenoma.

关 键 词：儿童 原发性甲状腺功能减退症 垂体增生 垂体瘤 替代治疗 

分 类 号：R72[医药卫生—儿科]