甲状腺激发激素分泌 pituitary adenoma:两个病例具有挑战性的诊断和管理
Elodie Gruneisen1,2, Juan Andres Rivera1
1Division of Endocrinology, McGill University Health Centre, Montréal, Canada.
Case reports in endocrinology
|April 22, 2025
概括
甲状腺激发激素 (TSH) 分泌的垂体腺瘤 (TSHomas) 是一种罕见的瘤,导致中央甲状腺功能障碍. 单独或手术后的多巴胺激动剂治疗在两个报告的病例中有效地管理了TSHomas.
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:
- 甲状腺激发激素 (TSH) 分泌的垂体腺瘤 (TSHomas) 是一种罕见的瘤,导致中央甲状腺功能障碍.
- 甲状腺瘤通常是具有并发症的宏腺瘤,微妙的甲状腺功能测试变化可能会推迟诊断.
- 其他垂体激素的过分分泌在TSHoma患者中很常见.
研究的目的:
- 报告了两例通过多巴胺激动剂 (DA) 治疗管理的TSHomas病例.
- 突出DA治疗在TSHoma管理中的潜在疗效.
- 强调监测甲状腺功能测试对于早期TSHoma检测的重要性.
主要方法:
- 两名TSHomas患者的病例报告.
- 治疗包括跨形手术 (TSS) 和/或多巴胺激动剂 (DA) 治疗.
- 评估了对DA治疗的生物化学和临床反应.
主要成果:
- 两个患有侵入性TSHomas的患者成功地接受了DA治疗.
- 一名患者患有多激素瘤 (Pit-1),患有高血,二次上腺功能衰竭和中央下腺功能衰竭.
- 两名患者都在DA治疗后出现了临床和生化改善,其中一名患者拒绝接受手术.
结论:
- 通过警的甲状腺功能测试监测,快速检测中央甲状腺功能障碍症对于TSHoma的诊断和管理至关重要.
- 产生TSH的腺瘤可能对多巴胺激动剂治疗有好反应.
- 多巴胺激动剂代表了TSHomas的可行的治疗选择,特别是当手术被拒绝或作为辅助治疗时.
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