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1、一228一中華內(nèi)分泌外科雜志2010年8月第4卷第4期ChinJEndocrSurg,August2010,Vo1.4,No.4·臨床研究·斜坡異位垂體腺瘤2例并文獻(xiàn)復(fù)習(xí)劉斌王勇【摘要】目的探討罕見的斜坡異位垂體腺瘤的臨床和影像學(xué)特點(diǎn)、診斷和治療。方法對(duì)我院收治的2例經(jīng)病理證實(shí)為斜坡異位垂體腺瘤進(jìn)行觀察,簡要復(fù)習(xí)相關(guān)文獻(xiàn),總結(jié)其臨床、神經(jīng)影像、診斷和治療等方面的特點(diǎn)。結(jié)果臨床表現(xiàn)為內(nèi)分泌紊亂或/和神經(jīng)功能障礙癥狀,影像檢查均顯示斜坡部位塊影。1例術(shù)前診斷為異位垂體腺瘤;1例術(shù)前誤診為脊索瘤。均采用單鼻孔一蝶竇入路,顯微手術(shù)切除腫
2、瘤。1例鏡下腫瘤全切,術(shù)后激素水平降至正常,隨訪1年無復(fù)發(fā);1例部分切除,術(shù)后并發(fā)腦脊液鼻漏和顱內(nèi)感染,治愈后失訪。結(jié)論斜坡異位垂體腺瘤主要表現(xiàn)為內(nèi)分泌紊亂或/和神經(jīng)功能障礙癥狀,顱腦MRI具有一定的診斷價(jià)值。盡管罕見,斜坡部位腫瘤的鑒別診斷也應(yīng)考慮此類腫瘤;手術(shù)全切腫瘤可獲得理想的療效?!娟P(guān)鍵詞】異位垂體腺瘤;斜坡【中圖法分類號(hào)】R736.4【文獻(xiàn)標(biāo)識(shí)碼】BEctopicpituitaryadenomainclivus:2casesreportandreviewoftheliteratureLIUBin,WANGy0.Depa
3、rtmentofNeurosurgery,HenanProvincialHospital,Zhengzhou450003,ChinaCorrespondingauthor:L1UBin,Email:brain1988cn@yahoo.corn.cn【Abstract】ObjectiveToexploreclinicalandneuroimaginefeatures,aswellasthemanagementofrareectopicpituitaryadenonminclivus.MethodsWereportedtwocase
4、sofectopicpituitaryadenomaverifiedbyhistologyintheclivusregion,reviewedtherelevantliteraturebriefly,summarizedtheclinicalandneuroimagingfeatures,alongwiththemanagementofeetopicpituitaryadenomainelivus.ResultsEctopicpituitaryadenomainclivuscausedsymptomsofendocrinopat
5、hyand/orneurologicaldysfunction.hnagingstudiesshowedanoccup—yinglesionintheclivus.Pituitaryadenomawasdiagnosedinonepatientpreoperatively,theotherwasdiagnosedaschordoma.Thetumorsweremierosurgicallyremovedthroughthetrans—sphenoidalroute.Tumorwasradicallyremovedinonepat
6、ient,andduringoue—yearfollow—up,therewasnorecurrence.Theotherwaspartiallyresec—ted,andsufferedpostoperativecerebrospinalfluidrhinorrheaandintracranialinfection,follow—upofthispatientlostfinally.ConclusionsThepatientswitheetopicpituitaryadenomainclivushaveendoerinopat
7、hyor/andneurologicaldysfunction,andMRIplaysavaluableroleinthediagnosis.Althoughextremlyrare,ectopicpituita—rytunlourneedstobeconsideredincaseofanoccupyinglesionintheclivus.Radicalresectionoftunlorcancurethepatient.【KeyWords】Ectopicpituitaryadenoma;Clivus垂體腺瘤幾乎均源于鞍內(nèi),當(dāng)
8、腫瘤增大時(shí)可向顱例1:肢端肥大4年,多食、多飲、多尿1月余收治。內(nèi)、外擴(kuò)展至鞍上或/和蝶竇等處;發(fā)生于上述部位之入院檢查:消瘦,肢端肥大。左眼視力0.6,右眼0.5,外的垂體腺瘤稱為異位垂體腺瘤。盡管異位垂體腺瘤視野無異常。空腹血糖18.38mmol/L,血生長