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[多激素垂体腺瘤(分泌生长激素/促肾上腺皮质激素/促甲状腺激素/促卵泡激素/促黄体生成素)的临床病例,诊断陷阱]

[Clinical case of plurihormonal pituitary adenoma (STH/ACTH/TSH/FSH/LH-secreting), diagnostic pitfalls].

作者信息

Kostyleva D N, Khandaeva P M, Lapshina A M, Przhialkovskaya E G, Belaya Zh E, Grigoriev А Yu, Mel'nichenko G A

机构信息

Endocrinology Research Centre.

出版信息

Probl Endokrinol (Mosk). 2024 Sep 15;70(4):24-31. doi: 10.14341/probl13349.

Abstract

According to numerous studies, the most common pituitary tumors are prolactinomas, reaching 60% of all clinically significant adenomas, the next in order are non-functional pituitary adenomas, somatotropinomas, corticotropinomas and thyrotropinomas. Plurigormonal tumors occur in less than 1% of all pituitary adenomas. The most common form of mixed secretion adenoma in this patient population, derived from the Pit-1 cell line, produces various combinations of hormones: growth hormone (GH), prolactin (PRL), thyroid-stimulating hormone (TSH). This article presents a patient with a plurihormonal two-component pituitary macroadenoma with a rare and exceptional combination of secreted hormones - GH / adrenocorticotropic hormone (ACTH) / TSH / follicle-stimulating hormone (FSH) / luteinizing hormone (LH) with minimal nonspecific clinical manifestations such as diabetes mellitus and poorly controlled arterial hypertension.

摘要

根据大量研究,最常见的垂体肿瘤是催乳素瘤,占所有具有临床意义腺瘤的60%,其次是无功能性垂体腺瘤、生长激素瘤、促肾上腺皮质激素瘤和促甲状腺激素瘤。多激素肿瘤在所有垂体腺瘤中发生率不到1%。在该患者群体中,源自Pit-1细胞系的最常见混合分泌腺瘤形式会产生多种激素组合:生长激素(GH)、催乳素(PRL)、促甲状腺激素(TSH)。本文介绍了一名患有多激素双成分垂体大腺瘤的患者,其分泌的激素组合罕见且特殊——GH/促肾上腺皮质激素(ACTH)/TSH/促卵泡激素(FSH)/促黄体生成素(LH),仅有如糖尿病和控制不佳的动脉高血压等轻微非特异性临床表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/667a/11551793/d4ed85f0c276/problendo-70-13349-g001.jpg

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