男性垂体泌乳素腺瘤的诊断和治疗

Prolactinoma in male

目的 分析总结男性垂体泌乳素腺瘤的诊断和治疗特点。方法 对 10年间 2 3例男性垂体泌乳素腺瘤患者的临床表现和肿瘤的病理学、内分泌学、影像学及治疗特点进行分析。结果 患者平均年龄 38 7岁。临床表现以性功能、视力视野障碍多见。患者平均血清泌乳素水平为 2 70 5 2 2±3 85ng ml,肿瘤平均高度为 30 41± 11 86mm ,78%的肿瘤呈侵袭性生长或向鞍上、鞍旁不规则生长。经手术及药物治疗后 ,患者泌乳素降至 6 41 5 4± 15 2 1ng ml (P <0 0 0 1) ;18例性功能障碍患者 8例改善 ;13例视力下降的患者 11例视力恢复正常或有不同程度改善 ;12例视野缺损的患者 10例视野恢复正常或改善。结论 男性泌乳素腺瘤患者具有年龄高、肿瘤大且多侵袭性生长、泌乳素水平高等特点。单一疗法难以取得满意效果 。

Objective To study the diagnostic and therapeutiic features of prolactinoma in male.Methods 23 male patients with prolactinoma patients in clinical manifestation, pathologic, endocrinological, radiographic and therapeutic features. Results The average age of the patients was 387. The major clinical manifestation were sexual and visual disfunction. Average serum prolactin was 270522±385ng/ml, average longitudinal diameter of the tumors was 3041±1186cm, and 78% of the tumors were invassive. After surgery and/or drug therapy, the average serum prolactin decreased to 64154±1521ng/ml(P<001), 8 of 18 patients improved in sexual function, 11 of 13 patients improved in eyesight and 10 of 12 in visual field. Conclusion For male patients with prolactinoma, the tumors were usually large and invassive, and serum prolactin levels were high. The patients were elder. Since the results of a single therapy were with less satisfactory, comprehensive therapy should be performed according to the feature of a given patient.