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卡麦角林治疗巨大泌乳素瘤后桥脑疝入颅底。

Pons herniation into skull base after cabergoline therapy of giant prolactinoma.

作者信息

Moles Herbera Jesús, Rivero Celada David, Montejo Gañan Inmaculada, Fustero de Miguel David, Fuentes Uliaque Carlos, Vela Marín Ana Carmen

机构信息

Department of Neurosurgery, Miguel Servet University Hospital, 1-3 Isabel la Católica Av., 50009, Zaragoza, Spain,

出版信息

Pituitary. 2015 Feb;18(1):68-71. doi: 10.1007/s11102-014-0558-9.

DOI:10.1007/s11102-014-0558-9
PMID:24522845
Abstract

INTRODUCTION

Pons herniation after cabergoline therapy for giant prolactinoma is a complication not documented in literature.

CASE REPORT

We report a medium aged patient who developed secondary hemiparesis after 18 months of medical treatment. MRI revealed pons herniation into the clivus. There was improvement with conservative treatment. Secuencial MRIs are presented showing the tumor at the moment of the diagnosis, tumor shrinkage and pons herniation.

DISCUSSION

Some studies have shown that a significant and rapid tumor shrinkage resulting from treatment with cabergoline can occur and it is thought that some complications are related with this tumor regression, as in the presented case.

摘要

引言

卡麦角林治疗巨大泌乳素瘤后发生脑桥疝是文献中未记载的一种并发症。

病例报告

我们报告一名中年患者,在接受药物治疗18个月后出现继发性偏瘫。磁共振成像(MRI)显示脑桥疝入斜坡。保守治疗后病情有所改善。呈现了系列MRI图像,显示诊断时的肿瘤、肿瘤缩小及脑桥疝情况。

讨论

一些研究表明,卡麦角林治疗可导致肿瘤显著快速缩小,并且认为一些并发症与这种肿瘤消退有关,如本病例所示。

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Pons herniation into skull base after cabergoline therapy of giant prolactinoma.卡麦角林治疗巨大泌乳素瘤后桥脑疝入颅底。
Pituitary. 2015 Feb;18(1):68-71. doi: 10.1007/s11102-014-0558-9.
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本文引用的文献

1
Giant prolactinomas: the therapeutic approach.巨大泌乳素瘤:治疗方法。
Clin Endocrinol (Oxf). 2013 Oct;79(4):447-56. doi: 10.1111/cen.12242. Epub 2013 Jun 11.
2
Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline.高泌乳素血症的诊断和治疗:内分泌学会临床实践指南。
J Clin Endocrinol Metab. 2011 Feb;96(2):273-88. doi: 10.1210/jc.2010-1692.
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Efficacy and safety of cabergoline as first line treatment for invasive giant prolactinoma.卡麦角林作为一线治疗药物治疗侵袭性巨大泌乳素瘤的疗效和安全性。
J Korean Med Sci. 2009 Oct;24(5):874-8. doi: 10.3346/jkms.2009.24.5.874. Epub 2009 Sep 24.
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Brain and optic chiasmal herniations into sella after cabergoline therapy of giant prolactinoma.卡麦角林治疗巨大泌乳素瘤后脑和视交叉向鞍内疝出。
Pituitary. 2011 Dec;14(4):384-7. doi: 10.1007/s11102-009-0179-x. Epub 2009 Apr 19.
5
Secondary deterioration of visual field during cabergoline treatment for macroprolactinoma.卡麦角林治疗大泌乳素瘤期间视野的继发性恶化
Clin Endocrinol (Oxf). 2009 Apr;70(4):588-92. doi: 10.1111/j.1365-2265.2008.03364.x. Epub 2008 Jul 31.
6
Effectiveness of long-term cabergoline treatment for giant prolactinoma: study of 12 men.长期使用卡麦角林治疗巨大泌乳素瘤的疗效:12例男性患者的研究
Eur J Endocrinol. 2007 Feb;156(2):225-31. doi: 10.1530/EJE-06-0646.
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The epidemiology of prolactinomas.催乳素瘤的流行病学
Pituitary. 2005;8(1):3-6. doi: 10.1007/s11102-005-5079-0.
8
Treatment of pituitary tumors: dopamine agonists.垂体肿瘤的治疗:多巴胺激动剂
Endocrine. 2005 Oct;28(1):101-10. doi: 10.1385/endo:28:1:101.
9
Giant prolactinomas in men: efficacy of cabergoline treatment.男性巨大泌乳素瘤:卡麦角林治疗的疗效
Clin Endocrinol (Oxf). 2003 May;58(5):662-70. doi: 10.1046/j.1365-2265.2003.01770.x.
10
Giant prolactinomas: clinical management and long-term follow up.巨大泌乳素瘤:临床管理与长期随访
J Neurosurg. 2002 Aug;97(2):299-306. doi: 10.3171/jns.2002.97.2.0299.