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关键词：垂体占位性病变；无功能腺瘤；垂体增生；Rathke囊肿
【摘要】 目的 探讨临床偶然发现的垂体占位性病变的诊断和处理。方法 系统分析1989～1997年34例CT和MRI偶然检出的垂体占位性病变的临床资料。结果 29例有头痛等颅内病变临床表现，仅3例表现轻度内分泌检查异常。34例中微型病灶占26例(77.5%)。26例经蝶手术切除病变，其病理诊断为：8例无功能大腺瘤，7例微腺瘤，5例垂体增生，6例Rathke囊肿。随诊23例无病变复发。结论 重视对慢性头痛患者行CT和MRI检查。对大于1.5cm或1.0～1.5 cm随诊期有病变增大证据者主张经蝶手术切除。而1.0 cm以下的病变应定期随诊。
Diagnosis and management of pituitary incidentolomas. SuChangbao,Ren Zuyuan,Wang Renzhi Yang Yi,Ma Wenbing,Lian Wei,Yang Zhong. Department ofNeurosurgery,Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing.100730. Tel:010 - 65296071
【Abstracts】Objective To discuss the diagnosis and managementof pituitary incidentolomas. Methods Clinical date of 34 patients withpituitary incidentolomas confined by CT or/and MRI has been made from 1989 to 1997. Results Among 29 cases with clinical manifestation presenting as headache and the like ofintracranial lesions,only 3 cases had slight abnormality in endocrinic investigation.Twenty six cases appeared microlesions(77.5%). Twenty six cases which underwenttranssphenoidal operative treatment and the pathological diagnosis was confirmed:8 caseswith non - functional pituitary macroadenoma,7 with microadenoma,5 with pituitaryhyperplasia and 6 with Rathkes cyst.No postoperative significant complication andmotality,no recurrence of lesion was found in the 23 follow - up cases. Conclusions CTand MRI examination should be necessary for the patients with chronicheadache.Transsphenoidal surgical resection should be considered for lesions larger than1.5cm or between 1.0cm and 1.5cm in diameter with the trend of enlargement of consideredthe lesions during the period of observation,while regular follow - up for lesionssmaller than 1.0cm in dianeter should be carried out.
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