Kluczyński Łukasz, Gilis-Januszewska Aleksandra, Godlewska Magdalena, Wójcik Małgorzata, Zygmunt-Górska Agata, Starzyk Jerzy, Hubalewska-Dydejczyk Alicja
Department of Endocrinology, Faculty of Medicine, Medical College, Jagiellonian University, 31-008 Krakow, Poland.
Department of Paediatric and Adolescent Endocrinology, Faculty of Medicine, Medical College, Jagiellonian University, 31-008 Krakow, Poland.
J Clin Med. 2021 Apr 14;10(8):1692. doi: 10.3390/jcm10081692.
Pituitary stalk lesions (PSL) are a very rare pathology. The majority of conditions affecting the infundibulum do not present with clinically apparent symptoms, what makes the diagnosis difficult. The recognition might be also complicated by the non-specific and transient characteristics of hormonal insufficiencies. In our study, we retrospectively analysed demographic, biochemical, and clinical long-term data of 60 consecutive, unselected adult patients (34 women and 26 men) with PSL diagnosed in the Department of Endocrinology, Jagiellonian University in Krakow. The diagnosis of PSL were categorized as confirmed, probable, or undetermined in 26, 26 and 8 patients, accordingly. Given the possible aetiology congenital, inflammatory, and neoplastic stalk lesions were diagnosed in 17, 15 and 20 patients, accordingly. In eight cases the underlying pathology remained undetermined. The most common pituitary abnormality was gonadal insufficiency diagnosed in 50.8% of cases. Diabetes insipidus was detected in 23.3% of cases. In 5% of patients the pituitary function recovered partially over time. Stalk lesions were extensively discussed in the context of the current literature. Based on the published data and our own experience a diagnostic algorithm has been proposed to help physicians with the management of patients with this challenging condition.
垂体柄病变（PSL）是一种非常罕见的病症。大多数影响漏斗部的病症并无明显的临床症状，这使得诊断变得困难。激素缺乏的非特异性和短暂性特征也可能使诊断复杂化。在我们的研究中，我们回顾性分析了60例连续、未经挑选的成年患者（34名女性和26名男性）的人口统计学、生化和临床长期数据，这些患者均在克拉科夫雅盖隆大学内分泌科被诊断为垂体柄病变。垂体柄病变的诊断被分类为确诊、可能或不确定，分别有26例、26例和8例。根据可能的病因，先天性、炎症性和肿瘤性柄部病变分别在17例、15例和20例患者中被诊断出来。在8例病例中，潜在病理仍未确定。最常见的垂体异常是性腺功能不全，在50.8%的病例中被诊断出来。23.3%的病例检测出尿崩症。5%的患者垂体功能随时间部分恢复。结合当前文献对柄部病变进行了广泛讨论。基于已发表的数据和我们自己的经验，提出了一种诊断算法，以帮助医生管理患有这种具有挑战性病症的患者。
