1、English Case reportEnglish Case reportDiagnosis and Therapy of Pituitary pseudotumor (pituitary thyrotroph hyperplasia)Neurosurgery Department 假性垂体瘤英文及病例1English Case reportEnglish Case report Nowadays more and more lesions in saddle area are found by CT and MRI especially pituitary adenoma.Do you t
2、hink all lesions in saddle area can be diagnosised pituitary adenoma?假性垂体瘤英文及病例2English Case reportEnglish Case report Many 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3Engl
3、ish Case reportEnglish Case reportWhat is so-called“Pituitary pseudotumor”or“pituitary hyperplasia”?假性垂体瘤英文及病例4English Case reportEnglish Case reportPituitary glandThyriod gland,suprarenal gland,ovarianhypothalamusThe axis of hormone control in our bodyControl functionReverse feedback假性垂体瘤英文及病例5Engl
4、ish Case reportEnglish Case report That 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 reportEnglish Case report The way that made these control goes is based on
5、 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 reportEnglish Case report Case 1 famale,15years,complained“delayed growth,acratia and a blur eyesight for 5 months”.Hormone tests showed decreased T3T4 level mardkedly high TSH level(75mIU/L)假性垂体瘤英文及病例8En
6、glish Case reportEnglish Case reportpicture 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 lesion and posthypophysis.Picture D shows a delayed growth of the bone in wrist(about 5-6years c
7、ompared to normal children).假性垂体瘤英文及病例9English Case reportEnglish Case report Now,do you still keep the diagnosis of pitutary adenoma in your mind?Why are the lesion not enhanced?How do you think about the thyriod hormone and TSH level?假性垂体瘤英文及病例10English Case reportEnglish Case report Indeed,there
8、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 scan.假性垂体瘤英文及病例11English Case reportEnglish Case reportSo,its pituitary pseudotumor.What is so-called“pituitary pseu
9、dotumor or pituitary hyperplasia”?physiologicalpathological adolescent pregnancy lactation Decreased function of the target gland the hormone therapy of great doesTumors that secrete hormone 假性垂体瘤英文及病例12English Case reportEnglish Case report The most likely cause of pituitary pseudotumor is decrease
10、d function of the target gland especially thyriod gland.These patients usually come for cure with the syndrome of acratia,edema,delayed growth.Sometimes with damage of eyesight.假性垂体瘤英文及病例13English Case reportEnglish Case report The less likely cause of pituitary pseudotumor is decreased function of
11、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 reportEnglish Case report The most important thing is precise dignosis and hormone therpy.Levothyroxine is usually accomdated,if needed,GH can be given at the sa
12、me time.The Hormone level should be checked usually.假性垂体瘤英文及病例15English Case reportEnglish Case report The 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16English Case reportEnglish Case reportBefore therpyAfter 3 months hormone therpy 假性垂体瘤英文及病例17English Case reportEnglish Case report假性垂体瘤英文及病例18
