老年鞍区脊索瘤合并垂体危象一例并文献复习

A Case of Senile Sellar Chordoma Complicated with Pituitary Crisis and Literature Review

报道1例老年鞍区脊索瘤合并腺垂体功能减退、垂体危象的诊治经过。患者因“双眼睑下垂伴复视2年,纳差1月”为主诉就诊。既往有多年糖尿病及高血压病史。检查患者有进行性低血压、低钠血症,血ACTH、TSH及睾酮均降低,PRL升高,FSH及LH均正常,磁共振显示鞍区斜坡-鞍上区占位性病变,肿瘤侵犯垂体,诊断为脊索瘤。给予补充糖皮质激素后低血压及低血钠逐渐好转。本文整理该病例的诊治经过,以此提高临床医师对脊索瘤的认识,及早诊治以减少相关不良结局的发生。

To report the diagnosis and treatment of 1 case of senile sellar chordoma with hypopituitarism and pituitary crisis.The patient was treated with the chief complaint of'double eyelid ptosis with diplopia for 2 years and anorexia for 1 month'.He had a history of diabetes and hypertension for many years.The patient had progressive hypotension,hyponatremia,decreased blood ACTH,TSH and testosterone,increased PRL,and normal FSH and LH.Magnetic resonance imaging showed a space-occupying lesion in the sellar slope-suprasellar region.The tumor invaded the pituitary gland and was diagnosed as chordoma.Hypotension and hyponatremia gradually improved after glucocorticoid supplementation.In this paper,the diagnosis and treatment process of the case is sorted out,so as to improve the clinicians'understanding of chordoma and early diagnosis and treatment to reduce the occurrence of related adverse outcomes.