与格雷夫斯病共存的混合甲状腺蛋白分泌的垂体神经内分泌瘤:一个病例报告
Yijing Huang1, Xiaoming Wen1, Xinxin Liang1
1Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
Frontiers in medicine
|September 19, 2024
概括
这项研究呈现了一种罕见的混合TSH PitNET与Graves病共存的罕见病例. 需要仔细考虑与格雷夫斯病的TSH PitNET,以防止瘤的进展.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 神经外科 神经外科
背景情况:
- 甲状腺激素 (TSH) 分泌的垂体神经内分泌瘤 (PitNETs) 是罕见的,混合的TSH PitNETs占病例的20-25%.
- TSH PitNETs与格雷夫斯病 (GD) 的同时存在非常罕见.
研究的目的:
- 报告一种与格雷夫斯病共存的混合TSH PitNET极为罕见的病例.
- 审查有关这种罕见疾病的现有文献.
主要方法:
- 一个案例展示了一个36岁的男性,甲状腺激素和IGF-1的水平升高,但TSH没有被抑制.
- 诊断工作包括甲状腺抗体,垂体MRI和PET-CT.
- 治疗涉及内镜下垂体瘤切除,其次是甲基马和lanreotide用于复发.
主要成果:
- 这名患者出现了甲状腺功能障碍的症状,并且IGF-1水平升高,甲状腺抗体呈阳性.
- 经手术后的甲状腺功能升高和TSH PitNET的复发得到证实.
- 用甲基马和兰胺治疗导致激素水平正常化和抗体的改善.
结论:
- 不被抑制的TSH和阳性甲状腺抗体增加的FT4和FT3表明潜在的TSH PitNET和GD.
- 仔细管理与GD共存的TSH PitNETs对于避免治疗诱导的瘤进展至关重要.
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