Hernandez Morin N, Huet D, Hautecouverture M
Service d'Endocrinologie et Métabolisme, Hôpital Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris.
Ann Endocrinol (Paris). 2003 Jun;64(3):227-31.
We report here two cases of pituitary apoplexy or pseudoapoplexy revealing a gonadotroph adenoma. A 69-year-old man, who had just started antiandrogen treatment (Gn-RH agonist) for prostatic cancer, was admitted to neurosurgery emergency because of increasing headache and visual impairment. The CT-scan disclosed the presence of a large pituitary mass with lateral invasion of the left cavernous sinus. Hormonel testing showed panhypopituitarism. A few days later, diabetes insipidus appeared. The patient first received corticosteroid therapy and underwent surgical adenomectomy. Immunostaining of the tumor tissue was positive for FSHbeta, confirming the diagnosis of gonadotroph adenoma. Three months after surgery, the endocrine evaluation showed pituitary insufficiency. An 81-year-old man complained of mnemonic disorders. The CT-scan revealed a pituitary mass without extension. The Ophthalmological examination showed left temporal upper quadranopsia. Endocrinological tests with administration of GN-HR triggered headache and vomiting. A second CT-scan was unchanged. Hormone testing revealed increased serum levels of FSH and decreased serum levels of LH. Surgical management of the primary tumor was undertaken due to the visual field alteration. Immunohistochemical studies confirmed the diagnosis of gonadotroph FSHbeta adenoma.
我们在此报告两例以促性腺激素腺瘤为表现的垂体卒中或假卒中病例。一名69岁男性，因前列腺癌刚开始接受抗雄激素治疗（Gn-RH激动剂），因头痛加剧和视力障碍入住神经外科急诊。CT扫描显示存在一个大的垂体肿块，侵犯左侧海绵窦。激素检测显示全垂体功能减退。几天后，出现尿崩症。患者首先接受了皮质类固醇治疗，并接受了腺瘤切除术。肿瘤组织免疫染色FSHβ呈阳性，确诊为促性腺激素腺瘤。术后三个月，内分泌评估显示垂体功能不全。一名81岁男性主诉记忆障碍。CT扫描显示一个垂体肿块，无延伸。眼科检查显示左侧颞上象限偏盲。给予GN-HR进行内分泌测试引发头痛和呕吐。第二次CT扫描结果无变化。激素检测显示血清FSH水平升高，LH水平降低。由于视野改变，对原发肿瘤进行了手术治疗。免疫组织化学研究确诊为促性腺激素FSHβ腺瘤。
