斜坡异位垂体腺瘤2例并文献复习

Ectopic pituitary adenoma in clivus ： 2 cases report and review of the literature

目的 探讨罕见的斜坡异位垂体腺瘤的临床和影像学特点、诊断和治疗.方法 对我院收治的2例经病理证实为斜坡异位垂体腺瘤进行观察,简要复习相关文献,总结其临床、神经影像、诊断和治疗等方面的特点.结果 临床表现为内分泌紊乱或/和神经功能障碍症状,影像检查均显示斜坡部位块影.1例术前诊断为异位垂体腺瘤;1例术前误诊为脊索瘤.均采用单鼻孔-蝶窦入路,显微手术切除肿瘤.1例镜下肿瘤全切,术后激素水平降至正常,随访1年无复发;1例部分切除,术后并发脑脊液鼻漏和颅内感染,治愈后失访.结论 斜坡异位垂体腺瘤主要表现为内分泌紊乱或/和神经功能障碍症状,颅脑MRI具有一定的诊断价值.尽管罕见,斜坡部位肿瘤的鉴别诊断也应考虑此类肿瘤;手术全切肿瘤可获得理想的疗效.

Objective To explore clinical and neuroimagine features, as well as the management of rare ectopic pituitary adenoma in clivus. Methods We reported two cases of ectopic pituitary adenoma verified by histology in the clivus region, reviewed the relevant literature briefly, summarized the clinical and neuroimaging features, along with the management of ectopic pituitary adenoma in clivus. Results Ectopic pituitary adenoma in clivus caused symptoms of endocrinopathy and/or neurological dysfunction. Imaging studies showed an occupying lesion in the clivus. Pituitary adenoma was diagnosed in one patient preoperatively, the other was diagnosed as chordoma. The tumors were microsurgically removed through the trans-sphenoidal route. Tumor was radically removed in one patient, and during one-year follow-up, there was no recurrence. The other was partially resected, and suffered postoperative cerebrospinal fluid rhinorrhea and intracranial infection, follow-up of this patient lost finally. Conclusions The patients with ectopic pituitary adenoma in clivus have endocrinopathy or/and neurological dysfunction, and MRI plays a valuable role in the diagnosis. Although extremly rare, ectopic pituitary tumour needs to be considered in case of an occupying lesion in the clivus. Radical resection of tumor can cure the patient.