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病例报告及文献复习:鞍上区异位促甲状腺素分泌垂体腺瘤。

Case Report and Literature Review: Ectopic Thyrotropin-Secreting Pituitary Adenoma in the Suprasellar Region.

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2021 Mar 11;12:619161. doi: 10.3389/fendo.2021.619161. eCollection 2021.

Abstract

Ectopic thyrotropin-secreting pituitary adenoma (ectopic TSH-oma) is a rare disorder that is easily misdiagnosed in clinical work. We report one patient who presented with hyperthyroidism and a suprasellar mass. In this case, preoperative diagnosis of suprasellar ectopic thyrotropin-secreting pituitary adenoma was challenging. A literature review revealed that a total of 11 patients with ectopic TSH-oma were previously reported, and only our one case was diagnosed in the microadenoma stage. Most of the patients with TSH-oma or ectopic TSH-oma were middle-aged. We described ectopic TSH-oma in a child at length. We recommend that ectopic TSH-oma should be considered in the differential diagnosis of thyrotoxicosis syndrome to achieve an accurate, early diagnosis. The somatostatin suppression test and imaging examinations, such as magnetic resonance imaging and positron emission tomography/magnetic resonance imaging, could contribute to the diagnosis. Once the diagnosis was highly suspected, tumor resection could achieve a satisfying long-term outcome in ectopic TSH-oma.

摘要

异位促甲状腺素分泌垂体腺瘤(异位 TSH-oma)是一种罕见的疾病,在临床工作中容易误诊。我们报告了 1 例表现为甲状腺功能亢进和鞍上肿块的患者。在这种情况下,鞍上异位促甲状腺素分泌垂体腺瘤的术前诊断具有挑战性。文献复习显示,此前共报道了 11 例异位 TSH-oma 患者,而我们的病例仅在微腺瘤阶段被诊断出来。大多数 TSH-oma 或异位 TSH-oma 患者为中年。我们详细描述了 1 例儿童异位 TSH-oma。我们建议异位 TSH-oma 应纳入甲状腺毒症综合征的鉴别诊断,以实现准确、早期诊断。生长抑素抑制试验和影像学检查,如磁共振成像和正电子发射断层扫描/磁共振成像,有助于诊断。一旦高度怀疑诊断,肿瘤切除可在异位 TSH-oma 中获得满意的长期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a22c/7992000/ece3303fdcaa/fendo-12-619161-g001.jpg

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