Fahlbusch R, Schrell U
Acta Neurochir (Wien). 1985;75(1-4):125-35. doi: 10.1007/BF01406333.
On one hand pituitary microadenomas with autonomous character and those, which had been influenced by hypothalamic disorders, are summarized and discussed. On the other hand, the neurosurgical management of tumours, adjacent to or involved with the hypothalamus, are described. Endocrinologically active pituitary adenomas are characterized by their hormone excess of ACTH, GH, and prolactin. In Cushing's disease endocrine and clinical remission occurred in 74%. 3 patients out of this group showed a reincrease of ACTH after a period of remission, indicating a possible hypothalamic influence. In acromegaly the hypothalamic influence is also discussed. One patient with an ectopic GRF-producing tumour showing a reincrease of GH levels after successful transsphenoidal adenomectomy has been described. In microprolactinomas, 7 patients out of 45 showed a reincrease of prolactin-levels after a period of normalization, we also discussed hypothalamic disorders. Tumours with suprasellar extension such as macroadenomas without endocrine activity and meningiomas are removed nowadays with minimal risk for the life of the patients. In craniopharyngiomas radical excision is accompanied by a high risk of hypothalamic defects caused by mechanical lesions and possible secondary vasospasm. Finally the excision of a hamartoma growing from the floor of the third ventricle into the interpeduncular cistern is discussed. Up to now the successful excision could be documented by endocrinological data, which give no sign of further growth of the hamartoma.
一方面，对具有自主性特征的垂体微腺瘤以及受下丘脑疾病影响的垂体微腺瘤进行了总结和讨论。另一方面，描述了与下丘脑相邻或累及下丘脑的肿瘤的神经外科治疗方法。具有内分泌活性的垂体腺瘤的特征是促肾上腺皮质激素（ACTH）、生长激素（GH）和催乳素分泌过多。在库欣病中，74%的患者实现了内分泌和临床缓解。该组中有3例患者在缓解一段时间后促肾上腺皮质激素水平再次升高，表明可能存在下丘脑影响。在肢端肥大症中，也讨论了下丘脑的影响。描述了1例异位生长激素释放因子（GRF）分泌肿瘤患者，在成功经蝶窦腺瘤切除术后生长激素水平再次升高。在微催乳素瘤中，45例患者中有7例在催乳素水平正常一段时间后再次升高，我们也讨论了下丘脑疾病。如今，对于具有鞍上扩展的肿瘤，如无内分泌活性的大腺瘤和脑膜瘤，在切除时对患者生命的风险极小。在颅咽管瘤中，根治性切除伴随着因机械损伤和可能的继发性血管痉挛导致下丘脑损伤的高风险。最后，讨论了从第三脑室底部向脚间池生长的错构瘤的切除。到目前为止，内分泌学数据证明切除成功，没有迹象表明错构瘤会进一步生长。
