Kamiya Y, Jin-No Y, Tomita K, Suzuki T, Ban K, Sugiyama N, Mase M, Sakuma N, Kimura G
Third Department of Internal Medicine, Nagoya City University Medical School, Japan.
Endocr J. 2000 Dec;47(6):793-7. doi: 10.1507/endocrj.47.793.
We encountered a case with long-term remission of Cushing's disease due to pituitary apoplexy. The apoplexy of pituitary adenoma secreting adrenocorticotropin hormone was diagnosed by successive and timely magnetic resonance imaging when the symptoms of the patient were not yet severe and anterior pituitary dysfunction was only a transient reduction of growth hormone secretion. Seven years after the first episode of pituitary apoplexy, hypercorticism recurred, and pituitary magnetic resonance imaging showed a regrowth of the pituitary adenoma. A spontaneous remission of Cushing's disease without significant visual, neurologic or hormonal defects seems to be a much more common phenomenon than has been previously suggested. Cases with relapse after spontaneous remission of Cushing's disease are rare and the duration of remission in previous reports was within 5 years. We observed such a patient with a 7 year-remission caused by pituitary apoplexy. We consider that a careful long-term follow-up is required for patients with Cushing's disease whose remission was due to pituitary apoplexy.
我们遇到了一例因垂体卒中导致库欣病长期缓解的病例。当患者症状尚不严重且垂体前叶功能障碍仅为生长激素分泌的短暂减少时，通过连续且及时的磁共振成像诊断出分泌促肾上腺皮质激素的垂体腺瘤卒中。垂体卒中首次发作7年后，皮质醇增多症复发，垂体磁共振成像显示垂体腺瘤再生。库欣病自发缓解且无明显视力、神经或激素缺陷似乎是一种比之前认为的更为常见的现象。库欣病自发缓解后复发的病例很少见，之前报告中的缓解期在5年以内。我们观察到了这样一位因垂体卒中而缓解7年的患者。我们认为，对于因垂体卒中而缓解的库欣病患者，需要进行仔细的长期随访。
