- 期刊
Pituitary Adenomas in Adolescence - Ten-Year Experience and Literature Review
青少年人的腦垂線腫瘤
摘要
隨著醫學科技日新月異，藉由影像學的檢查，青少年人的腦垂腺瘤發現率已愈來愈多。青少年人的腦垂腺瘤約佔所有腦垂腺瘤的百分之六。因為青少年人的腦垂腺處於亢進狀態下，產生的腫瘤對青少女月經周期，不正常泌乳及青少男第二性徵表現的影響甚大。處於青春期的年青人，尤其是患有腦垂腺腫瘤的人和成年人的腦垂腺瘤，在腫瘤分類，臨床徵狀上，兩者是不同的。從臨床上來比較，成年人常因為腫瘤的腫塊效應而引起視力的問題或有神經上的問題而求診，在年紀比較大的成年人常同時併發視器官的退化而由眼科醫師轉介而來；另一方面，青少年人，尤其是女性，因為月經周期剛開始，常是因為月經不來、無月經而尋求醫療資源。在免疫酵素染色上，祕乳激素瘤為青少年人最常見腦垂腺瘤，其次為促腎上腺激素瘤。很少看見無功能性腫瘤，這和成年的病人是不同的。在顯微構造方面，青少年和成年人的腫瘤細胞大致上無很大的差異，我們的結論是，一青少年的腦垂腺瘤接受經蝶竇手術是安全的，二青少年的腦垂腺瘤大部份是有功能性的腫瘤，三若已呈現無初經或無第二性徵，術後需追加放射治療及荷爾蒙治療，成效都不錯。
關鍵字
無資料並列摘要
Pituitary adenomas account for Iess than6 % of all intracranial tumors in adolescence . Between November 1987 and october 1996, 8 patients were treated by transsphenoidal resection at Kaohsiung Medical College Hospital . This series in - cluded 4 girls and 4 boys with ages ranging from 14 to 19 years . Symptoms reflect - ing endocrine dysfunction such as scanty pubic hairs in males and amenorrhea in females , were more often found than neurological problems in all adolescents at presentation . Macroadenoma occurred in five of our eight cases ( 62 % ) of adoles - cent pituitary adenoma . In one case ( 12 % ) , the tumor was plurihormonal tumor . Long-term follow-up ( mean 4.5±2.7 years ) revealed the majority ofpatientshadgood endocrine function . Significant operative morbidity included steroid-induced psy - chosis in one patient and transient diabetes insipidus in three , which resolved in all three within two weeks . Our study showed that l ) pituitary tumors in children were uncommon , and when they occurred they were frequently large and invasive ; 2) the endocrine disturbance caused by pituitary adenomas alerted the patients to seek medical heIP more often than neurological deficit ; 3) in adolescence , almost all pi-tuitary adenomas were functioning ; nonfunctioning pituitary adenomas were rare in adolescence ; and 4) transsphenoidal surgery was feasible and safe in adolescence , even with poor pneumatization of the sPhenoid sinus , which remains controversial in the literature .