假性垂体瘤英文及病例 ppt课件.ppt

• Decreased function of the target gland
• the hormone therapy of great does
•Tumors that secrete hormone
English Case report
• The most likely cause of pituitary pseudotumor is decreased function of the target gland especially thyriod gland.
English 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)
• So, what led us to the misdiagnosis?
English Case report
What is so-called “Pituitary pseudotumor” or “ pituitary hyperplasia”?
English Case report
The axis of hormone control in our body
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
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 nothing was found in MRI scan.
• Do you think all lesions in saddle area can be diagnosised pituitary adenoma?
English Case report
• Many patients diagnosised pituitary adenoma preoperation was demonstrated to be hyperplasia or Pituitary pseudotumor ,but not tumor.
English Case report Diagnosis and Therapy of Pituitary pseudotumor
(pituitary thyrotroph hyperplasia)
Neurosurgery Department
English Case report
• Nowadays more and more lesions in saddle area are found by CT and MRI especially pituitary adenoma.
• These patients usually come for cure with the syndrome of acratia,edema,delayed growth. Sometimes with damage of eyesight.
English 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?
hypothalamus
Control function
Pituitary gland
Reverse feedback
Thyriod gland, suprarenal gland, ovarian
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
Englmonstrate a larger pitutary gland,which grow upward like a ball with a clear boundary. The optic nerve and chiasm were raised.There’s no difference between lesion and posthypophysis. Picture D shows a delayed growth of the bone in wrist(about 56years compared to normal children).
English Case report
So, it’s pituitary pseudotumor. What is so-called “pituitary pseudotumor or
pituitary hyperplasia”?
physiological
pathological
• adolescent • pregnancy • lactation