垂体生长激素腺瘤合并泌乳素腺瘤的临床病理特点及诊断治疗

目的分析垂体生长激素腺瘤合并泌乳素腺瘤的临床病理特点和治疗效果.方法经内分泌学及磁共振检查诊断的8例垂体生长激素腺瘤合并泌乳素腺瘤患者,男4例,女4例;平均年龄32.3岁;平均病程12个月;临床症状依次为头痛、面部改变、手足变大、身材高大、月经不调、闭经、泌乳、视力下降;所有患者均采取经口鼻蝶显微手术切除肿瘤.结果经口鼻蝶显微术后患者生长激素泌乳素高分泌状态明显缓解,症状明显改善,头痛不同程度缓解,月经不调、闭经有5例恢复正常,4例视力下降及泌乳消失.结论垂体生长激素腺瘤合并泌乳素腺瘤的确诊依赖于临床、病理及实验室检查,该型腺瘤的内分泌特征与侵袭性相关;手术切除是首选治疗方法.

Clinical pathology, diagnosis, and treatment of mixed growth hormone-and prolactin cell adenoma

Objective To discuss the clinical pathology and management of mixed growth hormone-and prolactin(GH-PRL)cell adenoma. Method Eight patients(4 men and 4 women, with the mean age of 32.3 year old and duration of symptoms 12 months)underwent examination of serum endocrine and magnetic resonance imaging. Clinical manifestations included headache, physiognomy of acromegalic patient, large pudgy hands and foots, menstrual dysfunction, amenorrhea, galactorrhea, and descending vision. Patients underwent transsphenoidal microsurgery of mixed GH-PRL pituitary adenoma between 1986 and 2004. Results The hypersecretion of GH and PRL was relieved after operation. Headache was obviously improved in all patients. In 5 cases the menstrual dysfunction and amenorrhea were recovered. In 4 cases the galactorrhea and descending vision disappeared. Conclusions The diagnosis of mixed GH-PRL pituitary adenoma can be made according to the results examination of serum endocrine, pathology and clinical manifestations. Its endocrine features are related to the invasion extent of the adenoma. The transsphenoidal approach is the preferred treatment for mixed GH-PRL pituitary adenoma.