뇌하수체 선종의 임상적 고찰

Abstract

[한글]

1965년 1월부터 1976년 12월까지 만11년간 연세대학교 외과대학 부속 세브란스병원에 입원한 뇌하수체선종 51예를 대상으로 임상적고찰을 하여 다음과 같은 결과를 얻었다.

51예의 뇌하수체선종중 색소염성선종 38예 ,호산성선종 12예, 혼합형 1예였으며 색소염성선종에서는 20대, 30대가 과반수 이상을 차지하였고, 호산성선종은 10대에서 60대까지 고루 분포하였고 혼합형 1예는 20대였다. 남녀비는 전뇌하수체선종에서는 1.7 : 1, 색소

염성선종 2.2 : 1 ,호산성선종은 1 : 1이었다. 환자의 주소는 색소염성선종에서는 시력장애 (92.1%), 두통 (65.8%), 내분비계증상 ( 15.8% ), 구토(2.6%)의 순이었으나, 호산성선종에서는 시력장애, 두통, 내분비계증상이 각각 41.7%였으며 전신쇠약감이 8.3%에서 있었다. 색소염성선종 38예중 35에서, 호산성선종 전예에서 단순두개골촬영소견상 터어키안의 중대가 있었다. 뇌혈관영술, 기뇌촬영, 뇌파검사, 뇌주사 및 척수액검사 결과는 각각 88.2% 83.3% 57.1%, 42.9%와 38.1 %에서 이상소견을 보였다. 갑상선기능검사, 기초대사량 및 24시간 소변내 17-KS 및 17-OHCS치는 다양하여 이러한 검사결과로는 뇌하수체선종의 유형을 구별하는데 도움이 되지 못하였다.

[영문]

Pituitary adenomas comprise 9 to 18 percent of all intracranial tumors. By far the great majority are chromophobe adenomas, which enlarge the sella as they grow. In addition to producing the sing and symptoms of hormone excess, these tumors may compress and destroy normal pituitary tissue within the sella turcica and produce hormonal deficiency states, or they may extend out the sella turcica to compress nervous structures in the vicinity.

Fifty-one cases of pituitary adenoma have been analyzed on clinical manifestations and laboratory studies. These include patients in whom the diagnosis of pituitary adenoma has been made over the last 11 years from January, 1965 till December, 1976 at Severance Hospital.

The results were as follows :

1. Among 51 cases , chromophobe adenoma were 38, acidoplilic adenoma 12, and mixed form 1.

2. Age distribution of pituitary adenoma was from 18 to 64 years. In chromophobe adenoma, more than 50% of patients were in the second and third decades, but acidophilic adenoma were diffusely distributed from first decade to sixth decade and one with mixed form was in the second decade.

3. The male and female ratio was 1.7:1, that of chromophobe adenoma was 2.2:1, and that of acidophilic adenoma was 1:1.

4. Chief complaints of patients with chromophobe adenoma were visual symptom (92.1%), headache(65.8), endocrine symptom (15.8), and vomitting(2.6%) in order, but those with acidophilic adenoma were visual symptom(41.7%), headache (41.7%), endocrine symptom(41.7%), and general weakness (8.3%).

5. Skull films taken in 35 of 38 patients with chromophobe adenoma, and in all patients with acidophilic adenoma demonstrated sella enlargement.

6. Comparing the diagnostic accuracy of carotid angiogram, PEG, EEG, brain scan and CSF, the positive results were 88.2%, 83.3%, 57.1%, 42.9% and 38.1%.