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肢端肥大症:医学和手术考虑。

Acromegaly: Medical and Surgical Considerations.

机构信息

Department of Neurological Surgery, Weill Cornell Medicine, 525 East 68th Street, Box 99, New York, NY 10065, USA.

Department of Neurological Surgery, Weill Cornell Medicine, 525 East 68th Street, Box 99, New York, NY 10065, USA.

出版信息

Otolaryngol Clin North Am. 2022 Apr;55(2):331-341. doi: 10.1016/j.otc.2021.12.007. Epub 2022 Mar 4.

Abstract

Acromegaly results from excessive secretion of insulinlike growth factor-1 and growth hormone, which most commonly occurs because of pituitary somatotrophinoma. Diagnostic features of acromegaly include elevated insulinlike growth factor-1 and growth hormone; lesion on brain MRI; and clinically dysmorphic features, such as soft tissue swelling, jaw prognathism, and acral overgrowth. Transsphenoidal resection is the primary therapy for individuals with acromegaly, even in the cases where gross total resection is not possible because of parasellar extension and cavernous sinus involvement. For recurrent or persistent disease after resection, systemic medications and stereotactic radiosurgery are used.

摘要

肢端肥大症是由胰岛素样生长因子-1 和生长激素分泌过多引起的,最常见于垂体生长激素细胞瘤。肢端肥大症的诊断特征包括胰岛素样生长因子-1 和生长激素升高;脑 MRI 上有病变;以及临床畸形特征,如软组织肿胀、下颌前突和肢端过度生长。经蝶窦切除术是肢端肥大症患者的主要治疗方法,即使由于鞍旁扩展和海绵窦受累而无法进行大体全切除也是如此。对于切除后复发或持续存在的疾病,可使用全身药物治疗和立体定向放射外科治疗。

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