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[转移性垂体疾病]

[Metastatic Pituitary Disorders].

作者信息

Novák V, Hrabálek L, Hampl M, Hoza J, Fryšák Z, Vaverka M

出版信息

Klin Onkol. 2017 Summer;30(4):273-281. doi: 10.14735/amko2017273.

Abstract

BACKGROUND

Pituitary metastases are a rare complication of generalized cancer. Metastases to the pituitary gland occur in only 1% of patients operated on for sellar tumor. The most common presenting symptom in patients with pituitary metastases is diabetes insipidus, whereas this is rare in those with pituitary adenoma.

MATERIAL AND METHODS

This publication presents the cases of two patients with pituitary metastases and a systematic review of the literature. English-language publications related to pituitary metastases and published from 1957 to 2016 were identified using the PubMed database.

RESULTS

A total of 131 publications containing information about 259 patients (121 female and 138 male; mean age, 57.3 years) were identified. The most often metastasized breast carcinoma (24.6%) and lung carcinoma (23.8%), followed by thyroid carcinoma (11.3%), renal cell carcinoma (7.8%), hepatocellular carcinoma (4.3%), colorectal carcinoma (3.5%), and malignant melanoma (3.5%). The most frequent initial symptoms were manifestations of diabetes insipidus (39.6%), anterior pituitary deficiency (44.9%), perimeter disorders (51.6%), headache (37.6%), cranial nerve palsy (33.5%), and pseudoprolactinemia (16.7%). Radiotherapy (67.8%) and surgical treatment (63.9%) were the most frequently used treatment.

CONCLUSION

The average survival time from the onset of metastatic disease was 11.8 months. Surgical therapy alone or in combination with radiation therapy does not prolong survival, but alleviates symptoms and improves quality of life.Key words: pituitary metastasis - diabetes insipidus - hypopituitarism - transsphenoidal surgery The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 1. 2017Accepted: 4. 4. 2017.

摘要

背景

垂体转移瘤是全身性癌症的一种罕见并发症。垂体转移在鞍区肿瘤手术患者中仅占1%。垂体转移瘤患者最常见的症状是尿崩症,而在垂体腺瘤患者中则很少见。

材料与方法

本文报道了2例垂体转移瘤患者的病例,并对相关文献进行了系统回顾。使用PubMed数据库检索1957年至2016年发表的与垂体转移瘤相关的英文文献。

结果

共检索到131篇文献,包含259例患者的信息(女性121例,男性138例;平均年龄57.3岁)。最常发生转移的是乳腺癌(24.6%)和肺癌(23.8%),其次是甲状腺癌(11.3%)、肾细胞癌(7.8%)、肝细胞癌(4.3%)、结直肠癌(3.5%)和恶性黑色素瘤(3.5%)。最常见的初始症状是尿崩症表现(39.6%)、垂体前叶功能减退(44.9%)、视野障碍(51.6%)、头痛(37.6%)、脑神经麻痹(33.5%)和假性催乳素血症(16.7%)。放疗(67.8%)和手术治疗(63.9%)是最常用的治疗方法。

结论

转移性疾病发病后的平均生存时间为11.8个月。单独手术治疗或联合放射治疗并不能延长生存期,但可缓解症状并改善生活质量。关键词:垂体转移瘤 - 尿崩症 - 垂体功能减退 - 经蝶窦手术 作者声明他们在研究中使用的药物、产品或服务不存在潜在利益冲突。编辑委员会声明该手稿符合ICMJE对生物医学论文的推荐标准。提交日期:2017年1月13日 接受日期:2017年4月4日

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