摘要
目的探讨生长抑素类似物奥曲肽在垂体促甲状腺素(TSH)瘤诊断和治疗中的作用。方法系统报告北京协和医院诊治的1例垂体TSH大腺瘤患者临床特点,采用99mTc-奥曲肽显像和鞍区MRI对肿瘤进行准确定位诊断。给予奥曲肽0.1mg,每8h皮下注射,10d,观察TSH水平和肿瘤大小的变化,经口鼻蝶窦行垂体瘤切除术,观察手术效果,并进行相关文献复习。结果TSH瘤奥曲肽显像呈阳性。单纯抗甲状腺药物治疗难以使甲状腺功能完全正常。奥曲肽治疗能快速有效使甲状腺功能控制至正常,经10d奥曲肽治疗,垂体肿瘤由3.0cm×2.0cm×2.5cm缩小至2.0cm×2.0cm×1.5cm,甲状腺肿大由Ⅲ度缩小为Ⅱ度。结论99mTc-奥曲肽显像可作为TSH瘤定位诊断的方法之一。奥曲肽治疗能有效控制继发性甲状腺功能亢进并缩小TSH瘤体积,可用作TSH瘤的常规手术前准备。
Objective To evaluate the efficacy of octreotide in the diagnosis and treatment of pituitary thyrotropin （TSH）-secreting adenoma. Methods A 34-year man presented with central hyperthyroidism and pituitary TSH-secreting macroadenoma was reported. ^99mTc-octreotide scan and magnetic resonance imaging were completed to make the location diagnosis of the adenoma. Octreotide in 0. 1 mg dose was subcutaneosly injected every 8 hours for 10 days. Serum TSH level and tumor size were observed and trans-sphenoidal adenoma resection was completed. Results Pituitary TSH-secreting adenoma displayed positive sign in ^99mTc-octretide scan. Antithyroid drug was of no help in depressing thyroid function to normal. However, octreotide treatment could revert thyroid function to normal rapidly. A significant shrinkage of tumor mass from 3.0 cm × 2. 0 cm ×2. 5 cm to 2. 0 cm × 2. 0 cm × 1.5 cm was observed and a shrinkage of thyroid gland from Ⅲ to Ⅱ also observed. Conclusions ^99m Tc-octretide scan is one of the useful tools for location diagnosis of TSH-secreting adenoma. Octreotide can effectively control central hyperthyroid and make tumor shrink, and it can be a satisfactory method of preoperative preparation for TSH- secreting adenoma.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2006年第11期910-913,共4页
Chinese Journal of Internal Medicine
关键词
促甲状腺素
垂体肿瘤
奥曲肽
治疗
Thyrotropin
Pituitary neoplasms
Octreotide
Treatment
