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Diagnosis and management of central hyperthyroidism due to thyrotropin-secreting pituitary adenoma
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 2
- DOI:
- 10.3760/j.issn:1001-2346.2004.02.014
- Key Word:
- 垂体TSH细胞腺瘤;中枢性甲亢;经蝶窦手术
Abstract： 目的研究分析少见的7例垂体TSH腺瘤所致中枢性甲亢患者的临床资料.方法男性6例,女性1例,平均年龄42.7岁,平均病程3.1年,平均延误诊断1.5年.7例均有不同程度的甲状腺增大和甲亢症状,4例有视野缺损.所有患者均有血浆游离T3、游离T4、T3和T4增高,TSH不被抑制,其中,4例TSH增高,3例TSH正常;3例行TRH试验,2例无反应,1例有反应.7例均行蝶鞍MRI检查,均为垂体大腺瘤和巨大腺瘤,直径2～5cm;对海绵窦均有不同程度的挤压或包绕,2例侵犯蝶窦.均行经口鼻蝶窦显微外科垂体腺瘤切除术,其中,1例术前外院曾行γ刀治疗,1例行二期开颅垂体腺瘤切除术,3例术后辅以放疗.结果术后病理均为垂体TSH细胞腺瘤.随访3个月至1年,甲状腺功能正常5例,蝶鞍MRI检查未见肿瘤6例.结论垂体TSH细胞腺瘤首选手术治疗,术后密切随访甲状腺功能和影像学检查,若发现异常,及时辅以放疗.早期诊断和治疗是预后的关键.
- [1]Losa M,Giovanelli M,Persani L,etc.Criteria of cure and follow-up of central hyperthyroidism due to thyrotropin-secreting pituitary adenomas.[J].1996.
- [2]Brucker-Davis F..Thyrotropin-Secreting Pituitary Tumors: Diagnostic Criteria, Thyroid Hormone Sensitivity, and Treatment Outcome in 25 Patients Followed at the National Institutes of Health[J].1999.
- [3]BECKERS ALBERT,ABS ROGER,MAHLER CHARLES,etc.Thyrotropin-Secreting Pituitary Adenomas: Report of Seven Cases[J].1991.
- [4]Bakheet SM,Muttair Z,Hammami MM,etc.Primary hypothyroidism-associated TSH-secreting pituitary adenoma/hyperplasia presenting as a bleeding nasal mass and extremely elevated TSH level.[J].1999,22(6).
- [5]B W, Scheithauer,K, Kovacs,R V, Randall,etc.Pituitary gland in hypothyroidism. Histologic and immunocytologic study.[J].1985,109.
- [6]Wilson Charles B..A decade of pituitary microsurgery[J].1984.
- [7]P, Beck-Peccoz,L, Persani,S, Mantovani,etc.Thyrotropin-secreting pituitary adenomas.[J].1996,45.