垂体腺瘤复发的诊断和治疗

目的 探讨垂体腺瘤复发的临床特点、诊断及治疗方法。方法 对我院１９９７～１９９９年收治的６７２例垂体肿瘤患者中，３８例复发垂体肿瘤作回顾性临床分析。结果 ３８例复发垂体腺瘤患者均经手术及病理证实，复发时间最短３个月，最长１８年，平均复发时间５．１年。复发临床表现主要为视觉功能障碍、垂体功能障碍和头痛等。ＣＴ和ＭＲＩ表现为类圆形肿物并强化。再次手术经额入路２５例，经蝶入路１３例。３５例有视觉功能障碍

Diagnosis and management of recurrent pituitary adenoma

Objective To discuss the clinical features, diagnosis and management of recurrent pituitary adenoma. Methods 38 cases of recurrent pituitary adenoma presented in our hospital during a period from January 1997 to May 1999 were analyzed retrospectively, and the relative references were reviewed. Results All cases were confirmed by surgery and pathology. The average recurrent interval of pituitary adenoma was 5.1 years, ranging from 3 months to 18 years. The main clinical manifestations were visual interference, pituitary dysfunction and headache. CT and MRI showed masses in the sellar region with contrast enhancement. Repeated surgeries were performed in 25 cases via transfrontal approach, 13 cases via transsphenoidal. Twenty nine of 35 cases with visual interference were resolved, no improvement was achieved in 6 cases. Ten of 13 cases with PRL above normal level recovered within one week after surgery and no death was seen. 31 cases were followed up, and showed satisfying results. Conclusions The diagnosis of recurrent pituitary adenoma mainly relies on the analysis of clinical manifestations, endocrinological and neuroradiological examinations. Operative management, medical treatment and radiation therapy are all treatment of choice for recurrent pituitary adenoma; while surgery is a main and effective method.