Bauman Craig A, Milligan James D, Labreche Tammy, Riva John J
Department of Family Medicine, McMaster University, Hamilton, ON Canada ; The Centre for Family Medicine Family Health Team, 25 Joseph Street, Kitchener, ON Canada N2G 4X6.
School of Optometry and Vision Science, University of Waterloo, Waterloo, ON Canada.
Chiropr Man Therap. 2016 Apr 11;24:12. doi: 10.1186/s12998-016-0093-z. eCollection 2016.
Nonfunctioning pituitary macroadenoma (NFPA) is a tumour of the endocrine system that is virtually always benign and can be difficult to detect. This case report is presented from the patient's perspective to highlight experiences that led to the eventual diagnosis of this condition.
A 48 year-old male experienced prolonged and unexplained reduced athletic performance worsening over five years. The patient reported decreased libido, which initiated a testosterone blood test. This confirmed reduced testosterone levels and resulted in an endocrinology referral. A subsequent dynamic contrast MRI of the pituitary region revealed a mass. The most frequent symptoms of NFPA are visual field defects, headaches and features of hypopituitarism (includes fatigue, dizziness, dry skin, irregular periods in women and sexual dysfunction in men).
Clinicians should consider this differential diagnosis in middle-aged athletes with diminished athletic performance from an unknown cause, test visual fields and inquire if symptoms of headaches or hypopituitarism are present.
无功能垂体大腺瘤（NFPA）是一种内分泌系统肿瘤，几乎总是良性的，且可能难以检测。本病例报告从患者角度呈现，以突出导致最终诊断该病症的经历。
一名48岁男性在五年间经历了运动表现长期且不明原因的下降，并逐渐恶化。患者报告性欲减退，这促使进行了睾酮血液检测。检测证实睾酮水平降低，随后患者被转诊至内分泌科。随后对垂体区域进行的动态对比MRI显示有一个肿块。NFPA最常见的症状是视野缺损、头痛和垂体功能减退的症状（包括疲劳、头晕、皮肤干燥、女性月经不规律和男性性功能障碍）。
临床医生应考虑对运动表现不明原因下降的中年运动员进行这种鉴别诊断，检查视野并询问是否存在头痛或垂体功能减退的症状。
