以中枢性尿崩症为首发症状的垂体转移癌的临诊应对  

Approach to the patient with pituitary metastases initially manifested as central diabetes insipidus

作　　者：郭丰[1] 王莎莎[1] 秦贵军[1] 李志臻[1] 赵艳艳[1] 栗夏莲[1] 吴丽娜[1] 王娇[1] 张莹[1] 任高飞[1] Guo Feng;Wang Shasha;Qin Guijun;Li Zhizhen;Zhao Yanyan;Li Xialian;Wu Lina;Wang Jiao;Zhang Ying;Ren Gaofei(Department of Endocrinology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌科,450052

出　　处：《中华内分泌代谢杂志》2022年第4期330-334,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81600647);河南省教育厅重点项目(20A320013)。

摘　　要：回顾性分析10例垂体转移癌患者的肿瘤来源、临床特征、影像学特点、诊断与鉴别诊断、治疗及预后。结果显示,10例患者就诊时平均年龄62.0岁,转移灶9例源于肺癌、1例源于乳腺癌。所有患者均以尿崩症起病,部分合并垂体前叶功能减退,以及头痛、视物模糊等占位效应。MRI均显示垂体柄及垂体后叶异常,其中4例表现出特征性"哑铃状"改变。3例表皮生长因子受体(EGFR)突变肺癌患者接受靶向治疗后,原发及垂体转移病灶均有改善。The data of 10 patients with pituitary metastases were retrospectively analyzed,including tumor origin,clinical features,imaging characteristics,diagnosis and differential diagnosis,treatment and prognosis.The results showed that the average age of 10 patients at the time of consultation was 62.0 years.Nine metastases were originated from lung cancer and one from breast cancer.All patients started with central diabetes insipidus,and some of them accompanied with hypopituitarism,as well as occupancy manifestations such as headache,blurred vision,etc.MRI showed abnormalities in the pituitary stalk and posterior pituitary,four of which showed characteristic"dumbbell-shaped"changes.Three patients with epidermal growth factor receptor(EGFR)-mutated lung adenocarcinoma revealed improvement in both primary lesion and pituitary metastases after targeted therapy.

关 键 词：垂体转移癌 中枢性尿崩症 腺垂体功能减退 影像学改变 靶向治疗 

分 类 号：R736.4[医药卫生—肿瘤]