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世界首演:经口机器人辅助切除鼻咽部异位垂体腺瘤。

World premiere: transoral robot-assisted excision for nasopharyngeal ectopic pituitary adenoma.

机构信息

Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, 40 rue Worth, Suresnes, 92 150, France.

School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 2 Av. de la Source de la Bièvre, Montigny-le-Bretonneux, 78 180, France.

出版信息

Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6705-6709. doi: 10.1007/s00405-024-08850-3. Epub 2024 Jul 31.

Abstract

BACKGROUND

Pituitary adenoma (PA), though rare, has seen increased incidence with widespread MRI use, enabling incidental diagnosis. Prevalence is approximately 1 case per 1000 in the general population. PAs are benign neoplasms, constituting 10 to 20% of intracranial tumours. Ectopic pituitary adenoma developed outside the sella turcica is exceptional. It may be hormonally active or not. These are called nonfunctional pituitary adenomas.

METHODS

Here is reported a case of a man in his eighties with a nasopharyngeal ectopic pituitary adenoma treated by robot-assisted excision using a combined route. CARE guidelines have been respected.

RESULTS

A man in his eighties, asymptomatic, underwent an MRI for dizziness, revealing a nasopharyngeal mass. Despite being asymptomatic, nasofibroscopy revealed a reddish oval-shaped tissue mass attached to the roof of the nasopharynx. Biopsy identified a neuroendocrine tumor G1/G2. Imaging showed no local invasion or distant metastases. A multidisciplinary team decided on a robot-assisted surgical excision through the mouth, coupled with nasal endoscopy. The procedure achieved complete excision with clear margins and no adverse event has occurred.

CONCLUSIONS

This unique case involved the successful transoral robot-assisted excision of a nasopharyngeal ectopic pituitary adenoma, highlighting an innovative surgical approach.

摘要

背景

尽管垂体腺瘤(PA)很少见,但由于广泛使用 MRI 检查,其发病率有所增加,从而能够偶然诊断出。在普通人群中,其患病率约为每 1000 例 1 例。PA 是良性肿瘤,占颅内肿瘤的 10%至 20%。鞍外异位垂体腺瘤在蝶鞍外发育是罕见的。它可能具有激素活性,也可能不具有。这些被称为无功能性垂体腺瘤。

方法

这里报告了一例 80 多岁的男性患者,患有鼻咽部异位垂体腺瘤,采用机器人辅助联合入路切除。已尊重 CARE 指南。

结果

一名 80 多岁的无症状男性因头晕接受 MRI 检查,结果显示鼻咽部有肿块。尽管无症状,但鼻纤维镜检查显示鼻咽顶部有一个红色椭圆形组织肿块。活检确定为神经内分泌肿瘤 G1/G2。影像学检查未发现局部侵犯或远处转移。多学科团队决定通过口腔联合鼻内镜进行机器人辅助手术切除。该手术实现了完全切除,切缘清晰,无不良事件发生。

结论

本例为成功经口机器人辅助切除鼻咽部异位垂体腺瘤,突显了一种创新的手术方法。

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