斜坡异位垂体腺瘤2例并文献复习

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1、一228一中华内分泌外科杂志2010年8月第4卷第4期ChinJEndocrSurg，August2010，Vo1．4，No．4·临床研究·斜坡异位垂体腺瘤2例并文献复习刘斌王勇【摘要】目的探讨罕见的斜坡异位垂体腺瘤的临床和影像学特点、诊断和治疗。方法对我院收治的2例经病理证实为斜坡异位垂体腺瘤进行观察，简要复习相关文献，总结其临床、神经影像、诊断和治疗等方面的特点。结果临床表现为内分泌紊乱或／和神经功能障碍症状，影像检查均显示斜坡部位块影。1例术前诊断为异位垂体腺瘤；1例术前误诊为脊索瘤。均采用单鼻孔一蝶窦入路，显微手术切除肿

2、瘤。1例镜下肿瘤全切，术后激素水平降至正常，随访1年无复发；1例部分切除，术后并发脑脊液鼻漏和颅内感染，治愈后失访。结论斜坡异位垂体腺瘤主要表现为内分泌紊乱或／和神经功能障碍症状，颅脑MRI具有一定的诊断价值。尽管罕见，斜坡部位肿瘤的鉴别诊断也应考虑此类肿瘤；手术全切肿瘤可获得理想的疗效。【关键词】异位垂体腺瘤；斜坡【中图法分类号】R736．4【文献标识码】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垂体腺瘤几乎均源于鞍内，当

8、肿瘤增大时可向颅例1：肢端肥大4年，多食、多饮、多尿1月余收治。内、外扩展至鞍上或／和蝶窦等处；发生于上述部位之入院检查：消瘦，肢端肥大。左眼视力0．6，右眼0．5，外的垂体腺瘤称为异位垂体腺瘤。尽管异位垂体腺瘤视野无异常。空腹血糖18．38mmol／L，血生长