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“过度生长：漏诊肿瘤”：无垂体腺瘤影像学证据且无异位来源的肢端肥大症一例报告

"Overgrowth: Missing a Tumor" Acromegaly without Imaging Evidence of Pituitary Adenoma and No Ectopic Source: A Case Report.

作者信息

Ong Nicodemus, Sy Rosa Allyn

机构信息

Department of Internal Medicine, Cardinal Santos Medical Center, Philippines.

Endocrine, Metabolic and Diabetes Section, Cardinal Santos Medical Center, Philippines.

出版信息

J ASEAN Fed Endocr Soc. 2017;32(2):173-177. doi: 10.15605/jafes.032.02.13. Epub 2017 Sep 6.

DOI:10.15605/jafes.032.02.13
PMID:33442103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7784194/
Abstract

Growth hormone - secreting pituitary adenomas are the cause of acromegaly in 95% of patients. In rare circumstances, a pituitary adenoma on magnetic resonance imaging cannot be found; hence, a search for an ectopic source of GH production is done. Even rarer is an acromegalic patient without an ectopic source and without imaging evidence of pituitary adenoma. We report a case of acromegaly with no evidence of a pituitary adenoma and no evidence of an ectopic source after imaging studies; who underwent medical therapy with improving biochemical and clinical parameters.

摘要

分泌生长激素的垂体腺瘤是95%肢端肥大症患者的病因。在极少数情况下，磁共振成像检查未发现垂体腺瘤；因此，需寻找生长激素产生的异位来源。更为罕见的是，肢端肥大症患者既无异位来源，也无垂体腺瘤的影像学证据。我们报告一例肢端肥大症患者，影像学检查后既无垂体腺瘤证据，也无异位来源证据；该患者接受药物治疗后生化和临床参数有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/7d91ae176285/JAFES-32-2-173-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/ff01d546742b/JAFES-32-2-173-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/8391fd1b8037/JAFES-32-2-173-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/98ba07fd8778/JAFES-32-2-173-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/9553c08a0972/JAFES-32-2-173-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/f06ffbe4f220/JAFES-32-2-173-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/c38ca4aa1dac/JAFES-32-2-173-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/6ddc2bcd649e/JAFES-32-2-173-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/7d91ae176285/JAFES-32-2-173-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/ff01d546742b/JAFES-32-2-173-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/8391fd1b8037/JAFES-32-2-173-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/98ba07fd8778/JAFES-32-2-173-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/9553c08a0972/JAFES-32-2-173-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/f06ffbe4f220/JAFES-32-2-173-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/c38ca4aa1dac/JAFES-32-2-173-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/6ddc2bcd649e/JAFES-32-2-173-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c38/7784194/7d91ae176285/JAFES-32-2-173-g008.jpg

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本文引用的文献

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Switching patients with acromegaly from octreotide to pasireotide improves biochemical control: crossover extension to a randomized, double-blind, Phase III study.将肢端肥大症患者从奥曲肽转换为帕西瑞肽可改善生化控制：一项随机、双盲、III期研究的交叉扩展
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Efficacy and safety of monotherapy by pegvisomant, a growth hormone receptor antagonist, in Japanese patients with acromegaly.生长激素受体拮抗剂培维索孟单药治疗日本肢端肥大症患者的疗效和安全性。
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Effects of lanreotide Autogel primary therapy on symptoms and quality-of-life in acromegaly: data from the PRIMARYS study.
兰瑞肽长效凝胶初始治疗对肢端肥大症症状及生活质量的影响：来自PRIMARYS研究的数据
Pituitary. 2016 Apr;19(2):149-57. doi: 10.1007/s11102-015-0693-y.
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Acromegaly: an endocrine society clinical practice guideline.肢端肥大症：内分泌学会临床实践指南。
J Clin Endocrinol Metab. 2014 Nov;99(11):3933-51. doi: 10.1210/jc.2014-2700. Epub 2014 Oct 30.
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Tumor shrinkage with lanreotide Autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial.兰瑞肽长效微球 120 mg 作为肢端肥大症一线治疗的肿瘤缩小：一项前瞻性多中心临床试验结果。
J Clin Endocrinol Metab. 2014 Apr;99(4):1282-90. doi: 10.1210/jc.2013-3318. Epub 2013 Jan 1.
6
Long-term safety of pegvisomant in patients with acromegaly: comprehensive review of 1288 subjects in ACROSTUDY.肢端肥大症患者使用培维索孟的长期安全性：ACROSTUDY 中 1288 例患者的综合评估。
J Clin Endocrinol Metab. 2012 May;97(5):1589-97. doi: 10.1210/jc.2011-2508. Epub 2012 Feb 22.
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Acromegaly with no pituitary adenoma and no evidence of ectopic source.无垂体腺瘤且无异位来源证据的肢端肥大症。
Indian J Endocrinol Metab. 2011 Sep;15 Suppl 3(Suppl3):S250-2. doi: 10.4103/2230-8210.84878.
8
Place of cabergoline in acromegaly: a meta-analysis.卡麦角林治疗肢端肥大症的疗效评价：一项荟萃分析。
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A prospective, multicentre study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of patients with acromegaly.一项前瞻性多中心研究，旨在调查长效重复注射用奥曲肽（奥曲肽LAR）在肢端肥大症患者初始治疗中的疗效、安全性和耐受性。
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