斜坡异位泌乳素垂体腺瘤1例临床分析并文献复习

Clinical analysis of one patient with ectopic prolactinoma in clivus and review of literatures

目的探讨斜坡异位泌乳素垂体腺瘤的诊断与鉴别诊断及治疗方法。方法回顾性分析1例经手术及术后病理检查确诊的斜坡异位垂体腺瘤患者的临床资料,并结合文献总结其临床特点。结果该例患者表现为高泌乳素血症,MRI检查发现斜坡病变,术前诊断为脊索瘤。采用内镜下单鼻孔经鼻蝶入路显微手术全切除肿瘤。肿瘤病理免疫组化检查泌乳素阳性,术后未完全降至正常,口服溴隐亭治疗,随访1年无复发。结论斜坡异位垂体腺瘤临床罕见,误诊率高;仍应采用以手术为主的综合治疗。

Objective To explore the diagnosis,differential diagnosis and treatment of ectopic prolactinoma in clivus.Methods The clinical data of one patient with ectopic pituitary adenoma（ EPA） in clivus underwent surgery and pathology results was retrospectively analyzed,and the clinical features with literature review were summarized.Results The cases was diagnosed as hyperprolactinemia,MRI showed clivus mass and preoperative diagnosis was chordoma.The tumors were totally resected through transendoscopic single nostril transsphenoidal approach.Pathological immunohistochemical test showed prolactin positive,the hyperprolactinemia not returned to normal after surgery,oral bromocriptine treatment to control it,follow-up of 1 year without recurrence.Conclusions Ectopic clivus pituitary adenoma was rarely in clinic and easily be misdiagnosed.We should continue to adopt a comprehensive treatment based on surgery.