垂体生长激素腺瘤合并结直肠癌:附8例报告

Growth hormone-secreting pituitary adenoma with concomitant colorectal cancer: a report of 8 cases

目的探讨垂体生长激素腺瘤合并结直肠癌的临床特征。方法回顾分析2006—2011年收治的8例垂体生长激素腺瘤合并结直肠癌的临床和病理资料。结果男6例,女2例;中位年龄59岁(48～69岁)。有垂体瘤肢端肥大病史10～30年,2例已行垂体瘤治疗。术前检测激素水平和MRI及CT影像学检查。经纤维结肠镜活检确定为结直肠癌。所有患者均按结直肠癌行手术治疗。分期为Dukes B,C期。术后均辅以化疗。术后并发症有肺部感染,高血压,高血糖,低钾血症等,均经对症处理好转,无吻合口瘘、腹腔感染等并发症;1例自动出院(后失访)。7例随访2～44个月,均健在。结论对垂体生长激素腺瘤合并结直肠癌患者,应先按结直肠癌进行综合治疗,视情况处理垂体腺瘤。

Objective To study the clinical characteristics of growth hormone（GH）-secreting pituitary adenoma with concomitant colorectal cancer. Methods The clinical and pathological data of 8 patients with GH-secreting pituitary adenoma and concomitant colorectal cancer admitted from 2006 to 2011 were retrospectively analyzed. Results There were 6 male and 2 female patients,and the median age was 59（48-69） years.The history of acromegaly caused by pituitary tumor of the patients ranged from 10 to 30 years.Two patients had undergone treatment for pituitary adenoma.The serum levels of hormones were detected and MRI/CT examinations were performed before surgery.All patients were diagnosed as having colorectal cancer by colonoscopic biopsy and all underwent radical operation for colorectal cancer.The clinical stages of the tumor were Dukes B and C.Adjuvant chemotherapy was given in all patients after surgery.The postoperative complications included pulmonary infection,hypertension,hyperglycemia,hypokalemia,etc.,which were all resolved by symptomatic treatments.No anastomotic fistula or abdominal infection occurred.One case was self-discharged from hospital against advice（and then was lost to follow-up）.The other 7 cases were followed up for 2 to 44 months and all were alive. Conclusions For patients with GH-secreting pituitary adenoma and concomitant colorectal cancer,the comprehensive treatments for colorectal cancer shoud be adopted first,and later the pituitary adenoma is treated according to the patient＇s situation.