催乳素腺瘤合并Rathke囊肿3例及文献复习

Prolactinoma combined with Rathke's cleft cyst: a report of three-case and literature review

目的探讨催乳素腺瘤合并Rathke囊肿(RCC)的临床特点,以提高诊治水平。方法回顾性分析3例催乳素腺瘤合并RCC的病例资料,并结合文献进行分析。术前MRI示腺瘤中存在无强化囊性结构,经蝶窦入路手术均在切除肿瘤时见到典型Rathke囊肿囊液。结果 1例术后病理提示催乳素腺瘤合并RCC,2例因囊性组织被吸引器吸除,病理仅见催乳素瘤组织。3例病人随访26~78个月,均未见复发。结论催乳素腺瘤合并RCC较罕见,两者间可能无因果关系。RCC因体积小在术前MRI诊断中易遗漏,当MRI提示垂体腺瘤中存在无强化的囊性结构时,应考虑合并RCC可能。此病变经蝶窦入路手术可确诊,手术疗效确切。

Objective To evaluate the clinical characteristics and improve the diagnosis and treatment ofprolactinoma combined with Rathke＇s cleft cyst （RCC）. Methods Clinical data of 3 patients with prolactinoma combined RCC were analyzed with literature review retrospectively. Non-enhancing cyst-like struc^u＇e was found co-existing with pituitary adenomas on preoperative MRI in the 3 cases. The presence of typical RCC lesion in the prolactinoma tissue was confirmed by transsphenoidal microsurgery in all 3 cases. Results Pathological examination confirmed prolactinoma combined RCC in one, and the cystic tissue was removed by aspirator and thus only prolactinoma tissue seen in 2 cases. During the follow-up period of 26 to 78 months, no tumor recurrence was found in all the patients. Conclusions Prolactinoma combined with RCC is very rare. There may be no causality between prolactinoma and RCC. And the small size of RCC is easy to be missed in the preoperative MRI diagnosis. When a non-enhancing cyst-like structure is found on MRI in patient with pituitary adenoma, the possibility of combining with Rathke＇s cleft cyst should be considered. This lesion can be definitely diagnosed by transsphenoidal surgery and surgery is effective.