垂体腺瘤放射治疗后诱发胶质母细胞瘤

Radiation induced Glioblastoma after Radiotherapy for Pituitary Adenoma

报告1例垂体腺瘤经放射治疗后诱发胶质母细胞瘤。患者为鞍区肿瘤，直径约3cm，不全切除术后9个月复发，再次行不全切除术。电镜及免疫组化染色均证实为垂体泌乳素细胞腺瘤。电镜下特点瘤细胞浆中分泌颗粒少，形态多样，哑铃状或泪滴状，有空晕。免疫组化染色PRL（泌乳素）阳性反应。第H次手术后行放射治疗。4年后出现右额叶肿瘤，大小6.0cm×5．8cm×4．2cm，行右额叶前部切除术。光镜示胶质母细胞瘤。免疫组化染色GFAP（胶质纤维酸性蛋白）及S－100（S-100蛋白）阳性反应，证实肿瘤为胶质起源。

A rare case of glioblastoma subsequent to radiotherapy for pituitary adenoma was described. A 35-year-old man suffered from a sellar tumor which was removed by subtotal resection, 3cm in the diameter, 9 months later recurrence was recognized and another incomplete removal was performed. By electron microscopy and immunohistochemical staining of the tumor, it was confirmed to be pituitary prolactinoma. Electron microscopy revealed small amount of pleomorphic neuroendocrine glanules in form of dumbbell or tear-drop like shape in tumor cells. Immunohistochemical staining was positive for pro1actin. Radiation therapy had been performed since recurrence. Four years later a tumor of right temporal lobe measuring 6. 0 × 5. 8 × 4. 2cm developed, and the right anterior temporal lobe was resected. Histological examination revealed glioblastoma. Immunohistochemical staining was positive for glial fibrillary acidic protein (GFAP) and S-lOo protein(S-100). It was confirmed that the tumor was originated from glioma tissues without doubt.