摘要
目的研究分析垂体功能性促性腺激素腺瘤女性患者的临床特征,以期达到早期诊断及治疗的目的。方法回顾性分析我院收治的5例垂体功能性促性腺激素腺瘤女性患者的临床特点及诊治经过。结果5例患者均为生育年龄女性,平均年龄38.8岁,临床表现为月经紊乱、溢乳、头痛和视野缺损。盆腔超声发现双侧卵巢增大,内见多房囊性无回声。性激素检查雌激素4377.65~12973.45 pmol/L,均值7800.66 pmol/L,而FSH和/或LH并未被异常升高的雌激素负反馈抑制,泌乳素(PRL)升高至1268.18~2794.16 nmol/L,均值1726.95 nmol/L。垂体磁共振(MRI)检查发现垂体大腺瘤样改变。5例患者均接受垂体腺瘤切除术,病理切片免疫组化检查提示FSH/LH阳性,术后随访至今(3~5年)无肿瘤复发迹象。结论当绝经前女性出现月经紊乱、溢乳、头痛、视野缺损、反复发生的卵巢多房囊肿、雌激素异常升高的同时促性腺激素未被负反馈抑制时,应行垂体核磁共振检查,如发现垂体肿瘤,应考虑垂体功能性促性腺激素腺瘤的诊断。垂体瘤切除手术是首选治疗。
Objective:To analyze the clinical characteristics of female patients with pituitary functional gonadotroph adenoma to achieve the purpose of early diagnosis and treatment.Methods:The symptoms and diagnostic process of 5 patients with functional gonadotroph adenoma who were treated in our hospital were retrospectively analyzed.Results:Five patients were all women of childbearing age,with an average age of 38.8 years.The clinical features characterized by abnormal uterus bleeding,galactorrhea,headache and visual field defects.Pelvic ultrasound showed that bilateral ovarian enlargement and multilocular recurrent cystic cysts.The estrogen levels were 4377.65-12973.45 pmol/L,average 7800.66 pmol/L.However,the levels of FSH and/or LH were not effectively inhibited by abnormally elevated estrogen level.The level of prolactin was 1268.18-2794.16 nmol/L,average 1726.95 nmol/L.Magnetic resonance imaging(MRI)examination of the pituitary gland revealed a large adenomatoid change.Every patient underwent lesion excision.Analysis of tumor samples revealed immune-positivity for FSH/LH in five patients.Post-operative follow-up(3-5years)indicated no evidence of tumor recurrence in these patients.Conclusions:Functional pituitary adenomas should be considered in the differential diagnosis of premenopausal women with irregular uterus bleeding,galactorrhea,headache,visual field defects,and multilocular recurrent cystic cysts.Pituitary MRI should be performed.If a pituitary tumor is found,the diagnosis of pituitary functional gonadotroph adenoma should be considered.Surgical excision is the first choice for the treatment of functional pituitary adenomas.
作者
王含必
姚勇
邓成艳
幸兵
王任直
WANG Han-bi;YAO Yong;DENG Cheng-yan;XING Bing;WANG Ren-zhi(Peking Union Medical College Hospital,Peking Union Medical College/Chinese Academy of Medical Sciences,Beijing 100730)
出处
《生殖医学杂志》
CAS
2020年第2期149-154,共6页
Journal of Reproductive Medicine
