Aaberg T M, Kay M, Sternau L
Department of Ophthalmology, University of Miami School of Medicine, Florida, USA.
Am J Ophthalmol. 1995 Jun;119(6):779-85. doi: 10.1016/s0002-9394(14)72785-0.
To illustrate how the ophthalmologist can distinguish a metastatic tumor to the pituitary from a pituitary adenoma through clinical, particularly ophthalmic, findings.
We studied three patients with metastatic disease to the pituitary. One patient had a history of breast cancer without known metastatic disease, and two patients had no previous diagnosis of malignancy. We reviewed the literature with respect to signs and symptoms that may differentiate such lesions from histologically benign pituitary adenomas.
Including our patients and the recent cases in the literature, 42% of patients with metastatic tumors had oculomotor palsies, compared with less than 5% of patients with pituitary adenomas. Of patients with metastatic tumors, 33% had diabetes insipidus, compared with 1% who had pituitary adenomas. Furthermore, with respect to differentiating a pituitary adenoma from a metastatic process, radiographic examinations were not helpful, and histopathologic examination was occasionally incorrect.
The ophthalmologist can potentially differentiate a metastatic tumor to the pituitary from a pituitary adenoma, thereby assisting in the proper treatment of patients.
阐述眼科医生如何通过临床检查结果，尤其是眼科检查结果，来区分垂体转移性肿瘤和垂体腺瘤。
我们研究了3例垂体转移性疾病患者。1例患者有乳腺癌病史但无已知转移性疾病，另外2例患者既往未诊断出恶性肿瘤。我们回顾了有关可能将此类病变与组织学上良性的垂体腺瘤区分开来的体征和症状的文献。
包括我们的患者及文献中的近期病例，42%的垂体转移性肿瘤患者出现动眼神经麻痹，而垂体腺瘤患者中这一比例不到5%。垂体转移性肿瘤患者中33%出现尿崩症，而垂体腺瘤患者中这一比例为1%。此外，在区分垂体腺瘤和转移瘤方面，影像学检查并无帮助，组织病理学检查偶尔也会出现错误。
眼科医生有可能区分垂体转移性肿瘤和垂体腺瘤，从而有助于患者的合理治疗。
