侵袭性垂体瘤的诊断与治疗 ——附2例误诊病例报道及文献复习

Diagnosis and treatment of invasive pituitary adenoma

摘要:

目的探讨侵袭性垂体瘤的特点和诊疗方法，以减少临床上对该病的误诊误治。方法通过报道2015~2016年诊治的2例曾在外院误诊误治的侵袭性垂体瘤病案，并结合文献对该病的特点及诊疗方式进行总结与分析。结果侵袭性垂体瘤因其侵袭性特点而容易被误诊为其他相似疾病，导致后续治疗方案的误差。目前该病尚缺乏统一、确切的诊断标准，其诊断主要依靠病史、术前影像学检查、术中探查和术后病理检查，治疗上仍以手术为主，药物为辅，该病的手术全切率较低，易复发。结论只有熟练掌握侵袭性垂体瘤的临床特点及诊疗方法，才能避免临床上误诊误治。

关键词:侵袭性垂体瘤|误诊|文献复习

Abstract:

ObjectiveTo discuss the characteristics, diagnosis and treatment of invasive pituitary adenoma (IPA) for reducing misdiagnosis and therapeutic error of this disease.MethodsTwo patients with IPA previously misdiagnosed in other hospitals were treated in Guangdong General Hospital in 2005 and 2006. The clinical data including characteristics, diagnosis and treatment of this disease were summarized and analyzed retrospectively in combination with literature review.ResultsDue to its invasive clinical behavior, IPA was easily misdiagnosed as other similar diseases, which led to subsequent treatment error. Owing to absence of uniform and exact diagnostic criteria, the diagnosis of IPA was usually established via medical history, preoperative imageological examinations, intraoperative findings and postoperative pathological examination. Surgery was the main treatment of IPA, and adjuvant medicine treatment was usually necessary. With low total resection rate, IPA was prone to relapse.ConclusionClinical misdiagnosis and therapeutic error of IPA can only be avoided by mastering the clinical features, diagnosis and treatment of this tumor.

Key words:Invasive pituitary adenoma| Misdiagnosis| Literature review