Growth Retardation as the Initial Manifestation of Intracranial Tumors: Report of Two Cases

顱內腫瘤是腦垂腺低能症的重要原因之一。腦垂腺低能症的患者必需有詳細的放射學檢查，以排除顱內腫瘤的可能性。因爲顱內腫瘤若不去治療處理的話，終會有生命危險，如果興治療時機延誤，也會造成無法回複的神經損傷。兩名因身材矮小的男孩，年齡分別是9歲和14歲，來本院內分泌門診檢查。由於他們的生長速度極爲緩慢，所以住院進一步檢查評估。理學檢查包括眼底及神經學檢查都是正常。實驗室檢查證實他們皆患生長激素缺乏的腦垂腺低能症。第一例的顱部X光發現在蝶鞍上方有鈣化的現象；第二例則完全正常。而第二例在半年前曾因頭部外傷在一家醫學中心做過電腦斷層掃描，據報告是正常，因此，第二例符合傳統的診斷爲特發性腦垂腺低能症。然而，頭部的核磁共振掃描卻發現這兩例均有顱內腫瘤，分別是顱咽瘤及生殖細胞瘤。經過了開刀及放射線治療，現這兩名病人情況不錯，沒有明顯的神經障礙，我們的經驗證明以核磁共振掃描頭部的蝶鞍部位以探尋腦垂腺低能症的原因是必要的。

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並列摘要

Two boys (9 years and 14 years old) were brought to visit our pediatric endocrine clinic with the chief complaint of short stature. Because of growth retardation, they were admitted for further evaluation. Physical examinations, including neurological examinations, were unremarkable but the laboratory examination confirmed the diagnosis of hypopituitarism in both patients. Skull radiography examinations showed some calcifications at suprasellar regions in the case 1 but negative findings in case 2. Furthermore, computed tomography (CT) of the head of case 2 performed at an outside hospital half a year before was reported to be normal, so case 2 fits the conventional diagnosis of idiopathic hypopituitarism. However, magnetic resonance image (MRI) study of the head disclosed that both of them are victims of an intracranial tumor, craniopharyngioma and germ cell tumors respectively. After surgical intervention, followed by radiotherapy, both patients were stable without any neurological deficit. Our experience confirmed that an MRI study of sellar region is warranted in search of the etiology of hypopituitarism.

並列關鍵字

MRI ； intracranial tumor ； growth hormone deficiency

國際替代計量

Growth Retardation as the Initial Manifestation of Intracranial Tumors: Report of Two Cases

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