生长激素释放型垂体微腺瘤被大腺瘤掩盖：一例双垂体腺瘤病例并文献复习。
Growth hormone-releasing pituitary microadenoma overshaded by a macroadenoma: a case of double pituitary adenomas and review of the literature.
机构信息
Department of Neurosurgery, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Department of Pathology, Faculty of Medicine Hospital, TOBB University of Economics and Technology, Ankara, Turkey.
出版信息
Br J Neurosurg. 2024 Oct;38(5):1144-1150. doi: 10.1080/02688697.2022.2076806. Epub 2022 Jun 3.
OBJECTIVES
Double pituitary adenoma is a rare entity that can pose a significant challenge. The incidence of double or multiple pituitary adenomas is ∼1% in autopsy cases and 0.4-1.3% in surgical series. Its definition varies, including 'double adenomas' in the literature in contrast to 'multiple adenomas', which is more specific and suitable. While some authors require separating topographically unique tumours, others have used a looser definition of separate immunohistochemistry.
CASE PRESENTATION
We presented the case of a 26-year-old patient with recurrent carpal tunnel syndrome symptoms, with double pituitary adenomas secreting growth hormone (GH) and thyroid-stimulating hormone (TSH). To date, 89 patients have been reported in the literature with symptomatic carpal tunnel syndrome, but only five had GH-TSH secretion.
CONCLUSIONS
Double adenoma resection is of great importance for ensuring successful biochemical treatment. To ensure a successful operation, a careful preoperative 3T MRI examination is of great importance.
目的
双垂体腺瘤是一种罕见的实体瘤，可能会带来重大挑战。尸检病例中双或多发性垂体腺瘤的发病率约为 1%，手术系列中为 0.4-1.3%。其定义各不相同，文献中的“双腺瘤”与更具体且适用的“多发性腺瘤”相对应。虽然有些作者需要分离具有独特解剖位置的肿瘤，而另一些作者则使用更宽松的免疫组织化学定义。
病例介绍
我们报告了一例 26 岁患者，患有复发性腕管综合征症状，其垂体腺瘤同时分泌生长激素（GH）和促甲状腺激素（TSH）。迄今为止，文献中已有 89 例有症状的腕管综合征患者，但仅有 5 例存在 GH-TSH 分泌。
结论
双腺瘤切除术对于确保生化治疗的成功至关重要。为确保手术成功，术前仔细的 3T MRI 检查非常重要。
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