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Granular cell tumour of the neurohypophysis: an unusual cause of hypopituitarism

机译:神经垂体的颗粒细胞瘤:垂体功能低下的异常原因

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SummaryGranular cell tumours (GCT) are rare, slow-growing, benign neoplasms that are usually located in the head and neck. They are more frequent in the female gender and typically have an asymptomatic clinical course, being diagnosed only at autopsy. Symptomatic GCT of the neurohypophysis are exceedingly rare, being less than 70 cases described so far. The authors report on a case of a 28-year-old male that presented to the Endocrinology clinic with clinical and biochemical evidence of hypogonadism. He also reported minor headaches without any major visual symptoms. Further laboratory tests confirmed hypopituitarism (hypogonadotrophic hypogonadism, central hypothyroidism and hypocortisolism) and central nervous system imaging revealed a pituitary macroadenoma. The patient underwent transcranial pituitary adenoma resection and the pathology report described a GCT of the neurohypophysis with low mitotic index. The reported case is noteworthy for the rarity of the clinicopathological entity.Learning points:Symptomatic GCTs are rare CNS tumours whose cell of origin is not well defined that usually give rise to visual symptoms, headache and endocrine dysfunction.Imaging is quite unspecific and diagnosis is difficult to establish preoperatively.Surgical excision is challenging due to lesion’s high vascularity and propensity to adhere to adjacent structures.The reported case is noteworthy for the rarity of the clinicopathological entity.
机译:总结颗粒细胞瘤(GCT)是罕见的,生长缓慢的良性肿瘤,通常位于头颈部。它们在女性中更为常见,并且通常具有无症状的临床过程,仅在尸检时才被诊断出。神经垂体的症状性GCT极为罕见,迄今为止描述的病例不到70例。作者报告了一例28岁男性的病例,该男性在性内科临床和生化方面表现出性腺功能减退的证据。他还报告了轻微的头痛,没有任何重大的视觉症状。进一步的实验室检查证实垂体机能减退(性腺功能减退性腺机能减退,中枢甲状腺功能减退和皮质醇功能减退),中枢神经系统影像学检查发现垂体大腺瘤。该患者接受了经颅垂体腺瘤切除术,病理报告描述了有丝分裂指数低的神经垂体的GCT。有临床意义的实体罕见。由于病变的高血管性和粘附于邻近结构的倾向,外科切除术具有挑战性。该病例值得临床病理学家的关注。

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