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异位蝶鞍内生长激素释放垂体腺瘤伴颅内动脉瘤

Ectopic Intrasphenoidal Growth Hormone Releasing Pituitary Adenoma Associated with an Intracranial Aneurysm.

作者信息

Cifuentes-Lobelo Hernando, Castañeda-Duarte Marcelo A, Ruiz-Diaz Diego, Cortes-Lozano William

机构信息

Department of Neurosurgery, Hospital Infantil Universitario de San José - Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud, Colombia.

Medical School, Hospital Infantil Universitario de San José - Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud, Colombia.

出版信息

Asian J Neurosurg. 2024 Jun 27;19(3):520-525. doi: 10.1055/s-0042-1757434. eCollection 2024 Sep.

DOI:10.1055/s-0042-1757434
PMID:39205895
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11349417/
Abstract

Pituitary adenomas are a type of of the most frequent intracranial tumors. These tumors can extend outside the sella, but very rarely originate ectopically to the sellar region. A 71-year-old patient presented to our institution, with prior clinical history of noncontrolled arterial hypertension and new-onset high-intensity pulsatile headache. Upon suspicion of a hypertensive emergency with probable brain compromise, a nonenhanced computed tomography of the head was performed. A mass within the sphenoid sinus was found. Endocrinological workup demonstrated a significant elevation of the growth hormone. As an incidental finding, a brain aneurysm was evidenced, which was treated endovascularly prior to the mass treatment. Subsequently, the patient successfully underwent a gross total resection through an endonasal transsphenoidal approach. Histopathological results were consistent with a pituitary ectopic adenoma. A postoperative improvement in levels of somatomedin C was documented postoperatively.

摘要

垂体腺瘤是最常见的颅内肿瘤类型之一。这些肿瘤可延伸至鞍外,但极少异位起源于鞍区。一名71岁患者因既往有未控制的动脉高血压和新发高强度搏动性头痛的临床病史前来我院就诊。怀疑有高血压急症并可能伴有脑功能损害,遂进行了头部非增强计算机断层扫描。发现蝶窦内有一肿块。内分泌检查显示生长激素显著升高。作为偶然发现,证实有脑动脉瘤,在治疗肿块之前先进行了血管内治疗。随后,患者通过鼻内镜经蝶窦入路成功接受了全切除手术。组织病理学结果与垂体异位腺瘤一致。术后记录到生长调节素C水平有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/a34028b6ada6/10-1055-s-0042-1757434-i2240002-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/5654b5fb1fc1/10-1055-s-0042-1757434-i2240002-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/95c94bb1f950/10-1055-s-0042-1757434-i2240002-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/5b672c6df42f/10-1055-s-0042-1757434-i2240002-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/a34028b6ada6/10-1055-s-0042-1757434-i2240002-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/5654b5fb1fc1/10-1055-s-0042-1757434-i2240002-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/95c94bb1f950/10-1055-s-0042-1757434-i2240002-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/5b672c6df42f/10-1055-s-0042-1757434-i2240002-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d002/11349417/a34028b6ada6/10-1055-s-0042-1757434-i2240002-4.jpg

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本文引用的文献

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Treatment and diagnosis of cerebral aneurysms in the post-International Subarachnoid Aneurysm Trial (ISAT) era: trends and outcomes.国际蛛网膜下腔动脉瘤试验(ISAT)后时代脑动脉瘤的治疗和诊断:趋势和结果。
J Neurointerv Surg. 2020 Jul;12(7):682-687. doi: 10.1136/neurintsurg-2019-015418. Epub 2020 Jan 20.
2
Ectopic pituitary adenoma of the TSH-secreting sphenoidal sinus with excellent response to somatostatin analogs. Theory of the embryogenesis and literature review from a clinical case.促甲状腺激素分泌型蝶窦异位垂体腺瘤对生长抑素类似物有良好的反应。从临床病例看胚胎发生理论和文献复习。
Steroids. 2020 Feb;154:108535. doi: 10.1016/j.steroids.2019.108535. Epub 2019 Nov 6.
3
Variability in Clinical Presentation and Pathologic Implications of Ectopic Pituitary Tumors: Critical Review of Literature.
异位垂体肿瘤的临床表现变异性及病理意义:文献综述
World Neurosurg. 2019 Feb;122:397-403. doi: 10.1016/j.wneu.2018.10.200. Epub 2018 Nov 4.
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A Consensus Statement on acromegaly therapeutic outcomes.肢端肥大症治疗结局的共识声明
Nat Rev Endocrinol. 2018 Sep;14(9):552-561. doi: 10.1038/s41574-018-0058-5.
5
Intra cavernous aneurysm of internal carotid artery masquerading as a pituitary adenoma: a case report.伪装成垂体腺瘤的颈内动脉海绵窦段动脉瘤:一例报告
BMC Res Notes. 2018 Apr 10;11(1):237. doi: 10.1186/s13104-018-3329-2.
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Diagnosis and Treatment of Pituitary Adenomas: A Review.垂体腺瘤的诊断与治疗:综述
JAMA. 2017 Feb 7;317(5):516-524. doi: 10.1001/jama.2016.19699.
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Acromegaly: an endocrine society clinical practice guideline.肢端肥大症:内分泌学会临床实践指南。
J Clin Endocrinol Metab. 2014 Nov;99(11):3933-51. doi: 10.1210/jc.2014-2700. Epub 2014 Oct 30.
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