Ishii Kota, Abe Ichiro, Kameda Wataru, Sugimoto Kaoru, Morinaga Yusuke, Ito Miiko, Takashi Yuichi, Abe Makiko, Hada Yurika, Takase Kaoru, Fujii Hideyuki, Ohishi Hanako, Ochi Kentaro, Yamao Yuka, Minezaki Midori, Kudo Tadachika, Higashi Toshio, Sonoda Yukihiko, Ishizawa Kenichi, Kobayashi Kunihisa
Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Chikusino, Fukuoka, Japan.
Intractable Rare Dis Res. 2019 Nov;8(4):239-244. doi: 10.5582/irdr.2019.01083.
Recent advances in imaging technology resulted in an increase in pituitary incidentalomas (PIs) detection. PIs were reported to be present in 1.6% persons with magnetic resonance imaging of the brain. Whereas, there were few studies about PIs with detailed investigation. We aimed to investigate the clinical and endocrinological characteristics of PIs. We evaluated 65 patients diagnosed with PIs who underwent detailed clinical and endocrinological evaluations. Of the 65 patients, 33 (50.8%) had non-functional pituitary adenomas (NFPAs), 11 (16.9%) had Rathke's cleft cysts (RCCs), 7 (10.8%) had functional pituitary adenomas (FPAs), 6 (9.2%) had benign extra-pituitary tumors (BEPTs), and 8 (12.3%) had malignant tumors (MTs). Compared with patients with NFPAs, those with MTs were significantly younger and had a significantly lower body mass index, lower prevalence of hypertension, and lower prevalence of dyslipidemia. Patients with MTs had significantly higher prevalence of central diabetes insipidus than those with NFPAs. In addition, patients with NFPAs had significantly higher prevalence of pituitary apoplexy than those with FPAs, BEPTs, and MTs. In conclusion, our study demonstrated clinical and endocrinological characteristics of PIs. Highly detailed clinical and endocrinological investigations should be performed for PIs. In addition, MTs should be considered in the differential diagnosis for young and lean patients with central diabetes insipidus.
成像技术的最新进展导致垂体意外瘤（PI）的检出率增加。据报道，在进行脑部磁共振成像的人群中，PI的发生率为1.6%。然而，关于PI进行详细调查的研究很少。我们旨在研究PI的临床和内分泌特征。我们评估了65例被诊断为PI并接受详细临床和内分泌评估的患者。在这65例患者中，33例（50.8%）患有无功能垂体腺瘤（NFPA），11例（16.9%）患有拉克氏囊肿（RCC），7例（10.8%）患有功能性垂体腺瘤（FPA），6例（9.2%）患有垂体外良性肿瘤（BEPT），8例（12.3%）患有恶性肿瘤（MT）。与NFPA患者相比，MT患者明显更年轻，体重指数显著更低，高血压患病率更低，血脂异常患病率更低。MT患者中枢性尿崩症的患病率明显高于NFPA患者。此外，NFPA患者垂体卒中的患病率明显高于FPA、BEPT和MT患者。总之，我们的研究展示了PI的临床和内分泌特征。应对PI进行高度详细的临床和内分泌检查。此外，对于患有中枢性尿崩症的年轻且体型偏瘦的患者，在鉴别诊断时应考虑MT。
