假性垂体瘤英文及病例__培训课件.pptVIP

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. 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. So, what led us to the misdiagnosis? English Case report What is so-called “Pituitary pseudotumor” or “ pituitary hyperplasia”? English Case report Pituitary gland Thyriod gland, suprarenal gland, ovarian hypothalamus The axis of hormone control in our body Control function Reverse feedback 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 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 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) English Case report 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.There’s no difference between lesion and posthypophysis. Picture D shows a delayed growth of the bone in wrist(about 5-6years compared to normal children). 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 ab