[Pituitary germinoma presenting as a pseudotumoral lymphocytic hypophysitis in a man].
[Pituitary germinoma presenting as a pseudotumoral lymphocytic hypophysitis in a man].
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[垂体生殖细胞瘤在男性中表现为假瘤性淋巴细胞性垂体炎]。
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
R. Maréchaud
中科院分区：
文献类型：
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作者：
F. Torremocha;S. Hadjadj;E. Menet;A. Kas;H. Bourgeois;P. Levillain;B. Bataille;R. Maréchaud
一名 45 岁男性因鞍区肿块延伸至右侧海绵窦而出现头痛和眼外肌麻痹。激素测定显示促性腺激素不足。经蝶手术切除发现淋巴细胞性垂体炎并伴有纤维化和坏死。尽管使用高剂量类固醇治疗（1 毫克/公斤/天）一个月，但假瘤仍快速生长。进行了进一步的生物学和组织病理学研究。结果显示，脑脊液 (CSF) B-人绒毛膜促性腺激素 (ss-HCG) 水平较高，为 12 UI/L（正常<5 UI/L），血浆 BHCG 水平正常，脑脊液和血浆甲胎蛋白水平不可检测。肿瘤细胞对胎盘碱性磷酸酶和波形蛋白表现出阳性反应性。这些发现与鞍内生殖细胞瘤引起的炎症淋巴细胞过程一致。化疗耐受性差，外部放疗无效。
A 45-year-old man presented with headaches and extraocular muscle palsy due to a sellar mass extending into the right cavernous sinus. Hormonal determinations revealed a gonadotrophic insufficiency. A transsphenoidal surgical removal revealed a lymphocytic hypophysitis with fibrosis and necrosis. Rapid growth of the pseudotumor was noted despite a high dose steroid therapy (1 mg/kg/d) for a month. Further biological and histopathological investigations were performed. They showed a high cerebrospinal fluid (CSF) B-human chorionic gonadotropin (ss-HCG) level of 12 UI/L (normal<5 UI/L), normal plasma BHCG level, and undetectable CSF and plasma alpha-fetoprotein levels. The tumors cells showed a positive reactivity for placental alkaline phosphatase and for vimentin. These findings were consistent with an inflammatory lymphocytic process caused by an intrasellar germinoma. Chemotherapy was ill-tolerated and external radiotherapy was ineffective.