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一例垂体癌脑脊液播散患者对替莫唑胺联合全脑及脊髓放疗反应良好:病例报告及文献复习

A Pituitary Carcinoma Patient With Cerebrospinal Fluid Dissemination Showing a Good Response to Temozolomide Combined With Whole-Brain and Spinal Cord Radiotherapy: A Case Report and Literature Review.

作者信息

Du Peng, Wu Xuefan, Lv Kun, Xiong Ji, Geng Daoying

机构信息

Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Research, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Front Oncol. 2022 Jul 12;12:890458. doi: 10.3389/fonc.2022.890458. eCollection 2022.

Abstract

Pituitary carcinoma (PC) is extremely rare, with its incidence only accounting for 0.1%-0.2% of pituitary tumor (PT). Existing histological features, including invasiveness, cellular pleomorphism, nuclear atypia, mitosis, necrosis, etc., can be observed in pituitary adenoma (PA), invasive PA (IPA) and PC. Invasion is not the basis for the diagnosis of PC. The diagnosis of PC is often determined after the metastases are found, hence early diagnosis is extraordinarily difficult. Owing to the conventional treatment for PC may not be effective, a large portion of patients survived less than one year after diagnosis. Therefore, it is of great significance to find an efficacious treatment for PC. We report a rare case of sparsely granulated somatotroph carcinoma with cerebrospinal fluid dissemination showing a favorable treatment response to temozolomide (TMZ) combined with whole-brain and spinal cord radiotherapy.

摘要

垂体癌(PC)极为罕见,其发病率仅占垂体瘤(PT)的0.1%-0.2%。垂体腺瘤(PA)、侵袭性垂体腺瘤(IPA)和垂体癌中均可观察到现有的组织学特征,包括侵袭性、细胞多形性、核异型性、有丝分裂、坏死等。侵袭并非垂体癌诊断的依据。垂体癌的诊断通常在发现转移后确定,因此早期诊断极其困难。由于垂体癌的传统治疗可能无效,大部分患者在诊断后存活时间不足一年。因此,找到一种有效的垂体癌治疗方法具有重要意义。我们报告了一例罕见的颗粒稀疏型生长激素细胞癌伴脑脊液播散的病例,该病例对替莫唑胺(TMZ)联合全脑和脊髓放疗显示出良好的治疗反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32b7/9321396/cf92635a597d/fonc-12-890458-g001.jpg

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