假性垂体瘤英文及病例课件

1、English Case reportDiagnosis and Therapy of Pituitary pseudotumor (pituitary thyrotroph hyperplasia) Neurosurgery Department 假性垂体瘤英文及病例1English Case reportDiagnosis English Case reportNowadays more and more lesions in saddle area are found by CT and MRI especially pituitary adenoma.Do you think all

2、lesions in saddle area can be diagnosised pituitary adenoma?假性垂体瘤英文及病例2English Case reportNowadays moEnglish Case reportMany patients diagnosised pituitary adenoma preoperation was demonstrated to be hyperplasia or Pituitary pseudotumor ,but not tumor.So, what led us to the misdiagnosis? 假性垂体瘤英文及病例3

3、English Case reportMany patienEnglish Case reportWhat is so-called “Pituitary pseudotumor” or “ pituitary hyperplasia”?假性垂体瘤英文及病例4English Case reportWhat is so-English Case reportPituitary glandThyriod gland, suprarenal gland, ovarianhypothalamusThe axis of hormone control in our bodyControl functio

4、nReverse feedback假性垂体瘤英文及病例5English Case reportPituitary gEnglish Case reportThat is to say “the shape and function of pituitary is controlled by hypothalamus and feedback-affected by target organs such as Thyriod gland suprarenal gland ovarian假性垂体瘤英文及病例6English Case reportThat is to English Case re

5、portThe way that made these control goes is based on the hormone, such as TSH, ACTH, PRL, FSH, LH, GH T3T4, virosterone, cortisol, E2假性垂体瘤英文及病例7English Case reportThe way thaEnglish Case reportCase 1 famale, 15years, complained “delayed growth ,acratia and a blur eyesight for 5 months”. Hormone test

6、s showed decreased T3T4 level mardkedly high TSH level(75mIU/L)假性垂体瘤英文及病例8English Case reportCase 1 假性垂体English Case reportABCDpicture A-C demonstrate a larger pitutary gland,which grow upward like a ball with a clear boundary. The optic nerve and chiasm were raised.Theres no difference between lesi

7、on and posthypophysis. Picture D shows a delayed growth of the bone in wrist(about 5-6years compared to normal children).假性垂体瘤英文及病例9English Case reportABCDpictureEnglish Case reportNow, do you still keep the diagnosis of pitutary adenoma in your mind?Why are the lesion not enhanced?How do you think

8、about the thyriod hormone and TSH level?假性垂体瘤英文及病例10English Case reportNow, do youEnglish Case reportIndeed, there are something strange in this case which can not be eaplained by pitutary adenoma.After the therapy of levothyroxine for 3 month, the complaint disappeared and nothing was found in MRI

9、scan. 假性垂体瘤英文及病例11English Case reportIndeed, theEnglish Case reportSo, its pituitary pseudotumor. What is so-called “pituitary pseudotumor or pituitary hyperplasia”?physiologicalpathological adolescent pregnancy lactation Decreased function of the target gland the hormone therapy of great doesTumors

10、 that secrete hormone 假性垂体瘤英文及病例12English Case reportSo, its piEnglish Case reportThe most likely cause of pituitary pseudotumor is decreased function of the target gland especially thyriod gland. These patients usually come for cure with the syndrome of acratia,edema,delayed growth. Sometimes with

11、damage of eyesight.假性垂体瘤英文及病例13English Case reportThe most liEnglish Case reportThe less likely cause of pituitary pseudotumor is decreased function of the target gland of ovarian and suprarenal gland with the syndrome of lactation, advanced menstruation and puberfy. 假性垂体瘤英文及病例14English Case reportT

12、he less liEnglish Case reportThe most important thing is precise dignosis and hormone therpy.Levothyroxine is usually accomdated, if needed, GH can be given at the same time. The Hormone level should be checked usually.假性垂体瘤英文及病例15English Case reportThe most imEnglish Case reportThe MRI scan should be made after 3 months therapy. If the lesion decreased,we call it pituitary pseudotumor and take the way of “look-and-see” .If it grows, surgical therpy should be considered.假性垂体瘤英文及病例16Englis