Regional Centre for Diabetes and Endocrinology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK.
Ir J Med Sci. 2012 Jun;181(2):277-9. doi: 10.1007/s11845-009-0313-9. Epub 2009 Mar 14.
Pituitary tumours that present with nasal symptoms are uncommon. Management can be difficult due to their aggressive nature, location and extension.
We report a series of three cases of prolactinomas that enlarged inferiorly presenting initially as nasal polyps.
Recurrence of symptoms (case 1) prompted testing for serum prolactin and examination of histology confirmed the presence of a prolactinoma. In cases 2 and 3, radiological evidence of a pituitary mass prompted testing for a prolactinoma. No patients exhibited clinical signs of hyperprolactinaemia. All three cases have residual tumour at 2-4 years after diagnosis, despite prolactin levels approaching the normal range on dopaminergic therapy.
Pituitary tumours that invade the nasal cavity are rare and clinicians should be aware of their existence. A prolactinoma should be considered in the differential diagnosis of nasopharyngeal tumours. Measurement of serum prolactin can expedite a diagnosis and prevent delay of treatment with dopamine agonists.
表现出鼻部症状的垂体肿瘤并不常见。由于其侵袭性、位置和扩展，治疗可能会很困难。
我们报告了三例最初表现为鼻息肉的向下生长的泌乳素瘤病例。
症状复发（病例 1）促使检测血清泌乳素，组织学检查证实存在泌乳素瘤。在病例 2 和 3 中，垂体肿块的放射学证据提示检测泌乳素瘤。没有患者表现出高泌乳素血症的临床迹象。尽管多巴胺能治疗后泌乳素水平接近正常范围，但在诊断后 2-4 年内，所有 3 例仍有肿瘤残留。
侵犯鼻腔的垂体肿瘤很少见，临床医生应该意识到它们的存在。在鉴别诊断鼻咽肿瘤时，应考虑泌乳素瘤。测量血清泌乳素可以加速诊断，并防止延迟使用多巴胺激动剂治疗。
