垂体细胞瘤的临床特征和治疗策略（附11例报告）

Clinical features and treatment strategies of pituicytomas： a report of 11 cases

目的探讨垂体细胞瘤的临床特征和治疗策略，为临床诊治提供依据。方法回顾性分析2010年4月至2015年4月北京普仁医院一首都医科大学附属北京天坛医院神经外科合作病房收治的11例垂体细胞瘤患者的临床资料，包括临床表现、影像学特征、内分泌学和组织病理学特征、手术情况及随访结果。垂体细胞瘤患者主要临床表现为视力、视野障碍以及生长发育迟缓。肿瘤1例位于鞍上区，10例位于鞍区和鞍上区。术前实验室检查结果提示1例存在血催乳素增高，1例生长激素水平低下，其余患者均未见内分泌异常。随访时间为1～55个月，平均17．5个月。结果11例均行显微外科手术治疗，其中全切除8例，近全切除3例。10例患者复查MRI肿瘤未见复发，临床症状缓解或？肖失。仅1例因肿瘤复发行二次手术治疗。结论垂体细胞瘤的临床表现以视神经受压症状为主，术前诊断困难。经额外侧或翼点入路手术容易控制术中出血，亦能避免对腺垂体的损伤，为治疗垂体细胞瘤的主要方法。

Objective To investigate the clinical features and treatment strategies of pituicytomas in order to provide evidence for the clinical diagnosis and treatment. Methods The clinical data of the 11 patients with pituieytoma admitted to the cooperative wards of the Departments of Neurosurgery, Beijing Puren Hospital and Beijing Tiantan Hospital, Capital Medical University from April 2010 to April 2015 were analyzed retrospectively, including the clinical presentations, characteristics of imaging, characteristics of endocrinology and pathology, operation and follow-up results. The major clinical manifestations in patients with pituieytoma were visual disturbance, visual obstruction, growth retardation, and endocrine abnormalities. One neoplasm was located at the suprasellar region and 10 at the sellar and suprasellar region. In addition to 1 patient with the increased prolacfin and 1 patient with decreased growth hormone in preoperative blood endocrine examination, all other patients did not have endocrine abnormalities. Eleven patients were followed up for 1 - 55 months （ mean 17.5 ）. Results All 11 patients were treated with microsurgery, 8 of them were totally reseeted, and 3 were near-totally resected. MRI reexamination did not reveal tumor recurrence in 10 patients. Their clinical symptoms were relieved or disappeared. Only 1 patient conducted the second procedure because of tumor recurrence. Conclusions The clinical manifestations of pituicytomas are mainly compression of optic nerve. The preoperative diagnosis is difficult. The bleeding is easy to control during operation via the frontolateral approach or pterional approach, and can also avoid damaee to the adenohypophysis. It is a main method for the treatment of Dituicytomas.