垂体瘤与原发性闭经

Pituitary tumor and primary amenorrhea

目的分析垂体泌乳素腺瘤性原发性闭经的临床特点并评价其治疗效果。方法回顾性分析我院1995～2000年收治的5例垂体泌乳素腺瘤引起的原发性闭经患者的临床资料。结果根据肿瘤类型及生长方向分别行经颅或经蝶入路手术,5例垂体瘤次全切除3例(侵蚀型),全切除2例(局限型)。所有患者视力障碍均明显改善,血清PRL水平有不同程度下降,但只有1例患者在术后辅以溴隐亭治疗时有药物依赖性月经。结论此型垂体泌乳素腺瘤侵袭性强,手术治愈率低,术后辅以溴隐亭治疗可提高疗效,增加治愈机会。

Objectives To investigate the clinical features of primary amenorrhea for pituitary prolactinoma and to evaluate the effectiveness of surgical treatment. Methods Clinical data of five patients with primary amenorrhea caused by pituitary prolactinoma were analyzed retrospectively. The tumors were classified into two types (E: enclosed in sella turcica; I: invasive) according to their invasiveness determined by the CT or MRI examinations. Transcranial and transsphenoidal approaches were employed to resect the tumors. Results Total removal were achieved in 2 intrasellar tumors and subtotal resection in the other 3 invasive tumors. Postoperatively, visual disturbances were improved markedly in all patients and serum PRL level reduced to some different extent, while in only one patient appeared normal menstrual cycle with dependence on bromocriptine. One patient (20 %) developed cerebrospinal fluid rhinorrhea after surgery and no other complications were observed. Conclusion Careful evaluation should be performed before surgically resecting the tumors because of its relatively low cure rate.