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颅咽管瘤

最后审阅: 10 Oct 2024
最后更新: 08 Sep 2021

小结

定义

病史和体格检查

关键诊断因素

  • 视力丧失
  • 巨颅症和脑积水
  • 生长迟缓
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其他诊断因素

  • 促性腺激素分泌不足导致的性腺机能减退症状(闭经、勃起功能障碍)
  • 头痛
  • 颅内压升高的症状(恶心、呕吐、感觉减退和复视)
  • 溢乳
  • 视神经萎缩
  • 烦渴/多饮
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危险因素

  • 年龄 5-14 岁
  • 年龄 50 至 70 岁
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诊断性检查

首要检查

  • 眼科评估;电脑化视野检查
  • 颅脑 MRI 检查(造影剂增强)
  • 脑 CT 检查(造影剂增强)
  • 血清催乳素
  • 血清生长激素 (growth hormone, GH)
  • 血清胰岛素样生长因子 1 (insulin-like growth factor 1, IGF-1)
  • 血清胰岛素样生长因子结合蛋白-3 (insulin-like growth factor binding protein-3, IGFBP-3)
  • 生长激素(GH)激发试验
  • 血清黄体生成素
  • 血清卵泡刺激素
  • 晨间血清睾酮
  • 血清促甲状腺激素和 T3/T4
  • 清晨血清皮质醇和促肾上腺皮质激素(ACTH)
  • 血清电解质
  • 尿和血清渗透压
  • 尿比重
  • 测骨龄的 X 线平片
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需考虑的检查

  • 组织学
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治疗流程

急症处理

初始治疗

持续性治疗

初始治疗后

撰稿人

作者

Marc C. Chamberlain, MD
Marc C. Chamberlain

Chief

Division of Neuro-Oncology

Department of Neurology and Neurological Surgery

University of Washington

Seattle Cancer Care Alliance

Seattle

WA

利益声明

MCC declares that he has no competing interests.

鸣谢

Dr Marc C. Chamberlain would like to gratefully acknowledge Dr Daniel L. Silbergeld, a previous contributor to this topic.

利益声明

DLS declares that he has no competing interests.

同行评议者

Larry Junck, MD

Professor of Neurology

Department of Neurology

University of Michigan

Ann Arbor

MI

利益声明

LJ declares that he has no competing interests.

Jeff Raizer, MD

Associate Professor of Neurology

Director of Medical Neuro-Oncology

Northwestern University

Chicago

IL

利益声明

JR declares that he has no competing interests.

Ramez Kirollos, MBChB, FRCS(Ed), FRCS(Eng), MD, FRCS(SN)

Consultant Neurosurgeon

Addenbrooke's Hospital

Cambridge University Hospitals NHS Foundation Trust

Cambridge

UK

利益声明

RK declares that he has no competing interests.

Keyoumars Ashkan, BA, BSc, MB BCh, MRCP, FRCS, FRCPS, FRCS(SN), MD

Consultant Neurosurgeon and Lead of Neuro-Oncology

King's College Hospital

London

UK

利益声明

KA declares that he has no competing interests.

Edwin S. Kulubya Jr., MD, MBA

Neurosurgical Research Fellow

UC Davis Medical Center

Sacramento

CA

利益声明

EK declares that he has no competing interests.

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