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1、English Case report,Diagnosis and Therapy of Pituitary pseudotumor(pituitary thyrotroph hyperplasia)Neurosurgery Department,假性垂体瘤英文及病例,1,English Case reportDiagnosis,English Case report,Nowadays more and more lesions in saddle area are found by CT and MRI especially pituitary adenoma.Do you think al
2、l lesions in saddle area can be diagnosised pituitary adenoma?,假性垂体瘤英文及病例,2,English Case reportNowadays mo,English 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
3、文及病例,3,English Case reportMany patien,English Case report,What is so-called“Pituitary pseudotumor”or“pituitary hyperplasia”?,假性垂体瘤英文及病例,4,English Case reportWhat is so-,English Case report,Pituitary gland,Thyriod gland,suprarenal gland,ovarian,hypothalamus,The axis of hormone control in our body,Con
4、trol function,Reverse feedback,假性垂体瘤英文及病例,5,English Case reportPituitary g,English 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,6,English Case reportThat i
5、s to,English Case report,The 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,7,English Case reportThe way tha,English Case report,Case 1 famale,15years,complained“delayed growth,acratia and a blur eyesight for 5 months”.
6、Hormone tests showed decreased T3T4 level mardkedly high TSH level(75mIU/L),假性垂体瘤英文及病例,8,English Case reportCase 1 假性垂体,English Case report,A,B,C,D,picture 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 dif
7、ference between lesion 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,9,English Case reportABCDpicture,English Case report,Now,do you still keep the diagnosis of pitutary adenoma in your mind?Why are the lesion not enh
8、anced?How do you think about the thyriod hormone and TSH level?,假性垂体瘤英文及病例,10,English Case reportNow,do you,English Case report,Indeed,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
9、nothing was found in MRI scan.,假性垂体瘤英文及病例,11,English Case reportIndeed,the,English Case report,So,its pituitary pseudotumor.What is so-called“pituitary pseudotumor or pituitary hyperplasia”?,physiological,pathological,adolescent pregnancy lactation,Decreased function of the target gland the hormone
10、therapy of great doesTumors that secrete hormone,假性垂体瘤英文及病例,12,English Case reportSo,its pi,English Case report,The 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,de
11、layed growth.Sometimes with damage of eyesight.,假性垂体瘤英文及病例,13,English Case reportThe most li,English Case report,The 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.,
12、假性垂体瘤英文及病例,14,English Case reportThe less li,English Case report,The 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,15,English Case reportThe most im,En
13、glish 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,16,English Case reportThe MRI sca,English Case report,Before therpy,After 3 months hormone therpy,假性垂体瘤英文及病例,17,English Case reportBefore ther,English Case report,Thank you!,假性垂体瘤英文及病例,18,English Case reportThank you!假,
