Peters Jessica, Gryn Oscar, Gerka-Stuyt John
Microbiology and Immunology, Des Moines University, Des Moines, USA.
Otolaryngology - Head and Neck Surgery, Western Reserve Hospital, Cuyahoga Falls, USA.
Cureus. 2023 Sep 10;15(9):e44985. doi: 10.7759/cureus.44985. eCollection 2023 Sep.
Pituitary neuroendocrine tumors (PitNETs) located in the nasopharynx are a rare occurrence. This case report highlights a case of a 64-year-old female diagnosed with a PitNET incidentally found in her nasopharynx. The tumor was initially seen on MRI, excised, and analyzed with immunohistochemistry, ultimately confirming an immature pituitary-specific positive transcription factor 1 (PIT1)-positive-lineage pituitary neuroendocrine tumor. The tumor contained thyrotropes, somatotrophs, and lactotrophs expressing thyroid stimulating hormone, growth hormone, and prolactin, respectively. These tumors have the potential to exhibit aggressive behavior and can disrupt the surrounding tissue. Furthermore, they can be clinically silent or, conversely, secrete multiple hormones, causing hyperthyroidism, hyperprolactinemia, and acromegaly. For these reasons, they are deemed high risk. Treatment includes surgical excision with or without anti-hormone medications prior to surgery. Medications such as somatostatin analogs are used to decrease tumor size and reduce excessive hormone excretion.
位于鼻咽部的垂体神经内分泌肿瘤（PitNETs）较为罕见。本病例报告着重介绍了一名64岁女性，其鼻咽部偶然发现患有PitNET。该肿瘤最初通过磁共振成像（MRI）发现，随后切除并进行免疫组织化学分析，最终确诊为未成熟的垂体特异性阳性转录因子1（PIT1）阳性谱系垂体神经内分泌肿瘤。肿瘤包含分别表达促甲状腺激素、生长激素和催乳素的促甲状腺细胞、生长激素细胞和催乳素细胞。这些肿瘤有可能表现出侵袭性，破坏周围组织。此外，它们在临床上可能无症状，或者相反，分泌多种激素，导致甲状腺功能亢进、高催乳素血症和肢端肥大症。因此，它们被视为高风险肿瘤。治疗方法包括手术切除，术前可使用或不使用抗激素药物。生长抑素类似物等药物用于缩小肿瘤大小并减少过量激素分泌。
