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小儿鞍区病变的诊断与管理

Diagnosis and management of pediatric sellar lesions.

作者信息

Jagannathan Jay, Dumont Aaron S, Jane John A Jr

机构信息

Department of Neurological Surgery, Health Sciences Center, University of Virginia, Charlottesville, Va., USA.

出版信息

Front Horm Res. 2006;34:83-104. doi: 10.1159/000091574.

Abstract

Pituitary region tumors in pediatric patients are largely comprised of craniopharyngiomas and pituitary adenomas, each with their unique considerations. Craniopharyngiomas account for the majority of pediatric sellar masses. Pituitary adenomas are relatively uncommon during childhood, although the incidence increases during adolescence. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinologic, ophthalmologic and neurologic testing are critical. The management of pituitary tumors varies depending on the entity. For most tumors, other than prolactinomas, transsphenoidal resection remains the mainstay of treatment. Less invasive modalities such as endoscopic transsphenoidal surgery, and stereotactic radiosurgery have shown promise as primary and adjuvant treatment modalities, respectively.

摘要

小儿垂体区肿瘤主要由颅咽管瘤和垂体腺瘤组成,每种肿瘤都有其独特的考量因素。颅咽管瘤占小儿鞍区肿块的大多数。垂体腺瘤在儿童期相对少见,不过在青春期发病率会升高。鞍区病变的诊断需要多学科协作,详细的内分泌、眼科和神经学检查至关重要。垂体肿瘤的治疗方法因肿瘤类型而异。对于大多数肿瘤,除催乳素瘤外,经蝶窦切除术仍是主要的治疗方法。侵入性较小的治疗方式,如内镜经蝶窦手术和立体定向放射外科手术,分别已显示出作为主要和辅助治疗方式的前景。

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