Fracassi Federico, Mandrioli Luciana, Shehdula Dardan, Diana Alessia, Grinwis Guy C M, Meij Björn P
Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
J Am Anim Hosp Assoc. 2014 May-Jun;50(3):192-7. doi: 10.5326/JAAHA-MS-5987. Epub 2014 Mar 21.
A 13 yr old castrated male vizsla was referred to the authors' institute because of polyuria, polydipsia, polyphagia, and weight loss. Pituitary-dependent hypercortisolism (PDH) was diagnosed by hormone testing and adrenal and pituitary imaging. Computed tomography (CT) revealed a pituitary mass measuring 21 mm in width. Medical therapy was initiated with trilostane. Despite adequate control of the hypercortisolemia, the polyuria and polydipsia persisted and the dog developed neurologic signs due to the pituitary mass effect. Pituitary transsphenoidal debulking surgery was performed and immunocytochemistry confirmed a corticotroph adenoma. The dog survived for 13 mo after surgery. Postmortem examination revealed an empty fossa without pituitary remnants and the presence of a malignant pheochromocytoma in the right adrenal gland. This case report demonstrates, for the first time, that a large pituitary adenoma in the dog may be treated successfully by pituitary surgery.
一只13岁去势雄性维兹拉犬因多尿、多饮、多食和体重减轻被转诊至作者所在机构。通过激素检测以及肾上腺和垂体成像诊断为垂体依赖性高皮质醇血症(PDH)。计算机断层扫描(CT)显示垂体有一肿物,宽度为21毫米。开始用曲洛司坦进行药物治疗。尽管高皮质醇血症得到了充分控制,但多尿和多饮仍持续存在,且该犬因垂体肿物效应出现了神经症状。进行了经蝶窦垂体肿物切除术,免疫细胞化学证实为促肾上腺皮质激素腺瘤。该犬术后存活了13个月。尸检发现蝶鞍空虚,无垂体残余组织,右侧肾上腺存在恶性嗜铬细胞瘤。本病例报告首次证明,犬的大型垂体腺瘤可通过垂体手术成功治疗。