异位垂体腺瘤的诊断与手术治疗（附9例报告）

目的探讨异位垂体腺瘤的诊断与手术治疗,提高术前诊断准确率和治疗效果。方法回顾性研究9例病检确诊的异位垂体腺瘤的临床表现、影像学表现、激素相关检查结果;根据异位的具体部位选择相应手术入路。结果本组9例异位垂体腺瘤中有内分泌症状者5例,但局灶压迫症状不典型;病变的MRI表现与一般垂体腺瘤相同,部位不典型,蝶窦和鞍上异位相对多见,而蝶鞍和垂体正常;功能性异位垂体腺瘤的激素相关检查符合一般垂体腺瘤表现;手术全切7例,并发症较轻,术后结合伽马刀治疗未见复发。结论激素相关检查有利于功能性异位垂体腺瘤的术前诊断和鉴别其他内分泌疾病,MRI表现对无功能性异位垂体腺瘤的鉴别诊断有一定帮助,合理的手术入路结合术后伽马刀治疗或放疗可获得良好疗效。

The diagnosis and surgical treatment of ectopic pituitary adenoma in 9 cases

Objective To discuss the diagnosis and surgical treatment of ectopic pituitary edenoma and increase the pre -operational diagnostic accuracy and therapeutical outcome. Methods Retrospectively analysis of the clinical manifestations, MRI results and hormone tests of 9 ectopic pituitary edenoma cases were performed. Surgical approach were selected according to specific ectopic location of tumors. Results 5 of 9 cases showed endocrine disorder symptoms, but local oppression symptoms were atypical, MRI showed similar signal character and atypical location of tumors compared to common pituitary edenoma; the hormone test results of the cases were accorded with common functional edenoma ;7 tumors were total removed by operation with minor complications, no reccurence occured after pest - operational gamma - knife. Conclusions Hormone - related tests are useful for pre - operation disgnosis of functional ectopic pi- tuitary edenoma and differentiating it from other endocrine diseases. MRI image characters are helpful to differentiate non - functional ectopic pituitary edenoma from other intracranial tumors. Rational surgical process combined with pest-operation gamma-knife can provide satisfactory clinical outcomes.