儿童及青少年垂体泌乳素腺瘤的临床特点及手术疗效

Clinical characteristics and surgical outcome of prolactinomas in children and adolescences

目的探讨儿童及青少年垂体泌乳素腺瘤的临床特点及手术治疗效果。方法回顾性分析36例儿童及青少年垂体泌乳素腺瘤病人的临床资料。术前影像学检查显示:微腺瘤4例,大腺瘤27例,巨大腺瘤5例;侵袭性腺瘤9例,均行经鼻蝶窦入路手术。结果肿瘤全切除32例(88.9%),次全切除4例(11.1%)。随访30例,时间1年,复发5例,其中药物治疗2例,再次手术治疗2例,放疗1例。结论经鼻蝶窦入路手术是儿童及青少年垂体泌乳素瘤的有效治疗方法。肿瘤具有侵袭性生长及复发倾向,术后可继续应用药物治疗,需定期复查垂体MRI及内分泌激素以评估肿瘤复发情况。

Objective To investigate the clinical characteristics and surgical outcome of pituitary prolactinomas in childem and adolescences. Methods Clinical data of 36 pituitary prolactinomas patients in childern and adolescences were analyzed retrospectively. Preoperative imaging examination showed that there were 4 patients with microadenomas, 27 with macroadenomas and 5 with giant adenomas. The invasive adenomas were found in 9 patients. All the patients received surgery via transsphenoidal approach. Results Total resection was achieved in 32 patients （88.9%） and subtotal resection in 4 （11.1%）. Thirty patients were followed up for one year. Tumor recurrence occurred in 5 patients including drug treatment in 2 patients, second surgery in 2 and radiotherapy in 1. Conclusions Transsphenoidal approach surgery is the effective treatment for prolactinomas in children and adolescences. The tumor has the tendency to grow aggressively and recur, and the medicine treatment may be continously used after surgery. The pituitary MRI and endocrine hormones should be regularly examined to evaluate the tumor recurrence.