CAJ | 학술논문

目的通过分析垂体促甲状腺素(TSH)分泌瘤的临床和影像学资料,了解其临床特点、治疗手段及治疗后的临床转归.方法分析复旦大学附属华山医院2006年至2013年住院的20例垂体TSH分泌瘤患者的临床表现、激素水平、影像学检查以及治疗后的随访结果.结果 20例患者的年龄为(40.0±14.5)岁,病程1个月～15年.13例(65％)患者表现为甲状腺毒症及甲状腺肿,9例(45％)患者出现颅内占位压迫所致的临床表现.所有患者均具备游离T3、游离T4升高伴TSH不被抑制以及影像学垂体瘤征象.20例患者经手术、生长抑素类似物、放射治疗等综合治疗后,18例患者甲状腺功能恢复正常,肿瘤缩小且稳定,1例患者复发,1例患者失访.结论垂体TSH分泌瘤患者主要表现为甲状腺毒症及垂体瘤征象,临床以手术和生长抑素类似物为一线治疗,辅以放射治疗,预后较佳.
목적 통과분석수체촉갑상선소(TSH)분비류적림상화영상학자료,료해기림상특점、치료수단급치료후적림상전귀.방법 분석복단대학부속화산의원2006년지2013년주원적20례수체TSH분비류환자적림상표현、격소수평、영상학검사이급치료후적수방결과.결과 20례환자적년령위(40.0±14.5)세,병정1개월～15년.13례(65％)환자표현위갑상선독증급갑상선종,9례(45％)환자출현로내점위압박소치적림상표현.소유환자균구비유리T3、유리T4승고반TSH불피억제이급영상학수체류정상.20례환자경수술、생장억소유사물、방사치료등종합치료후,18례환자갑상선공능회복정상,종류축소차은정,1례환자복발,1례환자실방.결론 수체TSH분비류환자주요표현위갑상선독증급수체류정상,림상이수술화생장억소유사물위일선치료,보이방사치료,예후교가.
Objective To explore the clinical characteristics of thyrotropin-secreting pituitary adenomas.Methods A total of 20 patients with thyrotropin-secreting pituitary adenomas hospitalized in Shanghai Huashan Hospital from 2006 to 2013 were enrolled in the study.The clinical features,hormone levels,imaging findings,treatment and follow-up data were reviewed and analyzed.Results Most of the patients were young and middle-aged with (40.0 ± 14.5) years old.The disease duration varied from 1 month to 15 years.Among them,13 cases (65 ％) presented with thyrotoxicosis and/or thyroid goiters and 9 (45％) presented with symptoms of intracranial compression.All patients had unsuppressed levels of thyroid stimulating hormone (TSH) with elevated levels of thyroid hormones.Pituitary lesions were found in all patients by neuroimaging.Pituitary adenomectomy,and/or somatostatin analogs and/or radiotherapy were applied in all patients after definitive diagnosis.Restored euthyroidism and shrinked pituitary adenomas with no progression were observed in 18 patients.Relapse was found in 1 patient and another patient was lost to follow up.Conclusions Thyrotropin-secreting pituitary adenomas mainly present with thyrotoxicosis and/or pituitary tumor.Comprehensive therapy,including adenomectomy,somatostatin analogues and radiotherapy,is often needed for the management.