Zampieri P, Scanarini M, Sicolo N, Andrioli G, Mingrino S
Surg Neurol. 1983 Dec;20(6):498-503. doi: 10.1016/0090-3019(83)90034-4.
Four cases of growth-hormone-secreting pituitary adenoma, with associated aspects of acromegaly and gigantism, are reported in patients aged 12-26. All of the patients had macroadenomas and were treated surgically, three by the transsphenoidal approach and one with a transfrontal craniotomy. Histologic examination revealed eosinophilic adenomas in three of the cases and a mixed eosinophilic--chromophobe adenoma in one, all with cellular irregularities (mitosis and cellular and nuclear polymorphism), local invasivity, or both. Because surgical treatment did not produce complete normalization of growth hormone levels, radiotherapy followed the operations in all four cases. In our opinion, the treatment of acromegalic gigantism poses more therapeutic problems than that of simple acromegaly, with combined treatment (surgical, radiation, and medical) often being necessary.
报告了4例分泌生长激素的垂体腺瘤病例，患者年龄在12至26岁之间，伴有肢端肥大症和巨人症的相关症状。所有患者均患有大腺瘤，并接受了手术治疗，3例采用经蝶窦入路，1例采用经额开颅手术。组织学检查显示，3例为嗜酸性腺瘤，1例为嗜酸性-嫌色细胞混合腺瘤，均有细胞异常（有丝分裂以及细胞和核多形性）、局部侵袭性或两者皆有。由于手术治疗未能使生长激素水平完全恢复正常，所有4例患者术后均接受了放射治疗。我们认为，与单纯肢端肥大症相比，肢端肥大性巨人症的治疗面临更多治疗问题，通常需要联合治疗（手术、放疗和药物治疗）。
