Academic Department of Endocrinology, Beaumont Hospital, Dublin, Ireland.
Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Clin Endocrinol (Oxf). 2019 Apr;90(4):506-516. doi: 10.1111/cen.13929. Epub 2019 Feb 11.
Patients with craniopharyngioma experience excess morbidity and mortality when compared with the background population and with other hypopituitary patients. Large, suprasellar tumours which form micropapillae into surrounding structures can cause hypothalamic damage before any therapeutic intervention; attempted gross total resection can lead to hypothalamic obesity, sleep disorders, thirst disorders and dysregulation of temperature as well as panhypopituitarism. The management of tumour bulk and the pathophysiology of hypothalamic complications have been reviewed extensively. We present a practical, clinical approach to management of hypothalamic disease in a patient with craniopharyngioma and highlight potential targets for future pharmacological or surgical intervention.
与背景人群和其他垂体功能减退患者相比，颅咽管瘤患者的发病率和死亡率更高。大型、鞍上肿瘤可在任何治疗干预之前形成微乳头进入周围结构，导致下丘脑损伤；试图进行大体全切除可导致下丘脑性肥胖、睡眠障碍、口渴障碍和体温失调以及全垂体功能减退。肿瘤体积的管理和下丘脑并发症的病理生理学已经得到了广泛的研究。我们提出了一种实用的临床方法来管理颅咽管瘤患者的下丘脑疾病，并强调了未来药物或手术干预的潜在靶点。
