妊娠後期に下垂体卒中を起こし緊急手術を必要としたプロラクチン産生下垂体腺腫の1例
プロラクチン産生下垂体腺腫に対してカベルゴリン (CAB) 内服加療中に妊娠した21歳女性. 妊娠判明後にCABは中止となった. 妊娠後期に両耳側半盲を認め, 高プロラクチン (PRL) 血症があり, MRIにて腫瘍内部に液面形成像と視交叉の圧排を認めた. 帝王切開術後に一期的に内視鏡下経鼻的下垂体腫瘍摘出術を行った. 病理組織学的所見はsparsely granulated lactotroph adenoma (SGLA) でaggressiveな所見を認めた. 術後視野障害の顕著な改善を認めた. 本症例では妊娠による生理的変化と妊娠判明後のCAB投与中止が下垂体卒中の発症と病理組織学的に...
Saved in:
| Published in | 脳神経外科ジャーナル Vol. 30; no. 2; pp. 146 - 151 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脳神経外科コングレス
2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.30.146 |
Cover
| Abstract | プロラクチン産生下垂体腺腫に対してカベルゴリン (CAB) 内服加療中に妊娠した21歳女性. 妊娠判明後にCABは中止となった. 妊娠後期に両耳側半盲を認め, 高プロラクチン (PRL) 血症があり, MRIにて腫瘍内部に液面形成像と視交叉の圧排を認めた. 帝王切開術後に一期的に内視鏡下経鼻的下垂体腫瘍摘出術を行った. 病理組織学的所見はsparsely granulated lactotroph adenoma (SGLA) でaggressiveな所見を認めた. 術後視野障害の顕著な改善を認めた. 本症例では妊娠による生理的変化と妊娠判明後のCAB投与中止が下垂体卒中の発症と病理組織学的にaggressiveな所見に影響を与えた可能性がある. このような症例では, 他科との連携による集学的なアプローチを用いた治療が求められる. |
|---|---|
| AbstractList | プロラクチン産生下垂体腺腫に対してカベルゴリン (CAB) 内服加療中に妊娠した21歳女性. 妊娠判明後にCABは中止となった. 妊娠後期に両耳側半盲を認め, 高プロラクチン (PRL) 血症があり, MRIにて腫瘍内部に液面形成像と視交叉の圧排を認めた. 帝王切開術後に一期的に内視鏡下経鼻的下垂体腫瘍摘出術を行った. 病理組織学的所見はsparsely granulated lactotroph adenoma (SGLA) でaggressiveな所見を認めた. 術後視野障害の顕著な改善を認めた. 本症例では妊娠による生理的変化と妊娠判明後のCAB投与中止が下垂体卒中の発症と病理組織学的にaggressiveな所見に影響を与えた可能性がある. このような症例では, 他科との連携による集学的なアプローチを用いた治療が求められる. |
| Author | 坂本, 誠 牧嶋, かれん 伊澤, 正一郎 長尾, 裕一郎 黒﨑, 雅道 中村, 陽祐 神部, 敦司 桑本, 聡史 梅北, 義久 |
| Author_xml | – sequence: 1 fullname: 中村, 陽祐 organization: 鳥取大学医学部感覚運動医学講座耳鼻咽喉・頭頚部外科学分野 – sequence: 1 fullname: 梅北, 義久 organization: 鳥取大学医学部病理学講座 – sequence: 1 fullname: 神部, 敦司 organization: 鳥取大学医学部脳神経医科学講座脳神経外科分野 – sequence: 1 fullname: 牧嶋, かれん organization: 鳥取大学医学部付属病院病理診断科 – sequence: 1 fullname: 坂本, 誠 organization: 鳥取大学医学部脳神経医科学講座脳神経外科分野 – sequence: 1 fullname: 伊澤, 正一郎 organization: 鳥取大学医学部統合内科医学講座循環器・内分泌代謝内科学分野 – sequence: 1 fullname: 長尾, 裕一郎 organization: 鳥取大学医学部脳神経医科学講座脳神経外科分野 – sequence: 1 fullname: 桑本, 聡史 organization: 鳥取大学医学部病理学講座 – sequence: 1 fullname: 黒﨑, 雅道 organization: 鳥取大学医学部脳神経医科学講座脳神経外科分野 |
| BookMark | eNo9kE1LAlEYhS9hkJmrfsfYe--dcWY2QUhfILQpaDfc-SoHs5iRoF3j4CKtjQpuIotIDLEWEUqQ_Zg7o_MzUgo358B54FmcVZQonZcshNYxZGRFkTcco-RlKGSwmF1CSYIVWaAYIIGSoGJZUCU4XkFpz3MAgBKaBZkm0WXUrUW9x2h8O7nvcL8fjurRQyX8bkZ3jXA04JVG_DnkfpP77emwNrl-mdzU46fmbI9-qnHX535vhrjf4UGbBwMevPLKOw98HnxMW8_TVmchjKtfcbXP_TccjutraNlmRc9K_3cKHe1sH-b2hPzB7n5uKy84BAgTdJNazFYIIZJCRFWyRFmnsmFSW2RUl0DCNgCWRAsrQEzVtKgJVNIpY4oNWMY0hTb_vI5XZieWduEWzph7pTG3XDCKljb_TKOgkXnMjlsA45S5msPoLxxnkYQ |
| ContentType | Journal Article |
| Copyright | 2021 日本脳神経外科コングレス |
| Copyright_xml | – notice: 2021 日本脳神経外科コングレス |
| DOI | 10.7887/jcns.30.146 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 2187-3100 |
| EndPage | 151 |
| ExternalDocumentID | article_jcns_30_2_30_146_article_char_ja |
| GroupedDBID | 2WC ALMA_UNASSIGNED_HOLDINGS JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j202a-bd3eaf8222582495e47b37cd3f4a3b5051f00154e1802d9de3d035b3aa8f01713 |
| ISSN | 0917-950X |
| IngestDate | Wed Sep 03 06:31:05 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 2 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j202a-bd3eaf8222582495e47b37cd3f4a3b5051f00154e1802d9de3d035b3aa8f01713 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jcns/30/2/30_146/_article/-char/ja |
| PageCount | 6 |
| ParticipantIDs | jstage_primary_article_jcns_30_2_30_146_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2021 |
| PublicationDateYYYYMMDD | 2021-01-01 |
| PublicationDate_xml | – year: 2021 text: 2021 |
| PublicationDecade | 2020 |
| PublicationTitle | 脳神経外科ジャーナル |
| PublicationTitleAlternate | 脳外誌 |
| PublicationYear | 2021 |
| Publisher | 日本脳神経外科コングレス |
| Publisher_xml | – name: 日本脳神経外科コングレス |
| References | 9) 西岡 宏, 井下尚子 : 下垂体腫瘍の2017年WHO組織分類. No Shinkei Geka 47 : 597-606, 2019. 5) Honegger J, Nasi-Kordhishti I, Aboutaha N, Giese S : Surgery for prolactinomas : a better choice? Pituitary 23 : 45-51, 2020. 2) Barraud S, Guédra L, Delemer B, Raverot G, Ancelle D, Fèvre A, Jouanneau E, Litré CF, Wolak-Thierry A, Borson-Chazot F, Decoudier B : Evolution of macroprolactinomas during pregnancy : a cohort study of 85 pregnancies. Clin Endocrinol (Oxf) 92 : 421-427, 2020. 6) Jemel M, Kandara H, Riahi M, Gharbi R, Nagi S, Kamoun I : Gestational pituitary apoplexy : case series and review of the literature. J Gynecol Obstet Hum Reprod 48 : 873-881, 2019. 13) Wakai S, Fukushima T, Teramoto A, Sano K : Pituitary apoplexy : its incidence and clinical significance. J Neurosurg 55 : 187-193, 1981. 11) 藤森敬也, 佐藤 章 : 脳神経外科疾患合併妊娠―周産期専門医. 周産期医学 36 : 1085-1089, 2006. 12) Stalldecker G, Mallea-Gil MS, Guitelman M, Alfieri A, Ballarino MC, Boero L, Chervin A, Danilowicz K, Diez S, Fainstein-Day P, García-Basavilbaso N, Glerean M, Gollan V, Katz D, Loto MG, Manavela M, Rogozinski AS, Servidio M, Vitale NM : Effect of cabergoline on pregnancy and embryo-fetal development : Retrospective study on 103 pregnancies and a review of the literature. Pituitary 13 : 345-350, 2010. 7) Molitch ME : Endocrinology in pregnancy : management of the pregnant patient with a prolactinoma. Eur J Endocrinol 172 : R205-213, 2015. 8) 成田善孝, 渋井壮一郎 : 脳腫瘍の治療結果を可視化する大規模データの収集・臨床試験の必要性―脳腫瘍全国集計調査報告の活用について―. 脳外誌 24 : 699-704, 2015. 14) Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF : A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 331 : 904-909, 1994. 1) Bălinişteanu B, Cîmpean AM, Ceauşu AR, Corlan AS, Melnic E, Raica M : High Ki-67 expression is associated with prolactin producing pituitary adenomas. Bosn J Basic Med Sci 17 : 104-108, 2017. 4) Bronstein MD, Paraiba DB, Jallad RS : Management of pituitary tumors in pregnancy. Nat Rev Endocrinol 7 : 301-310, 2011. 10) Piantanida E, Gallo D, Lombardi V, Tanda ML, Lai A, Ghezzi F, Minotto R, Tabano A, Cerati M, Azzolini C, Balbi S, Baruzzi F, Sessa F, Bartalena L : Pituitary apoplexy during pregnancy : a rare, but dangerous headache. J Endocrinol Invest 37 : 789-797, 2014. 3) Bronstein MD, Salgado LR, de Castro Musolino NR : Medical management of pituitary adenomas : the special case of management of the pregnant woman. Pituitary 5 : 99-107, 2002. |
| References_xml | – reference: 4) Bronstein MD, Paraiba DB, Jallad RS : Management of pituitary tumors in pregnancy. Nat Rev Endocrinol 7 : 301-310, 2011. – reference: 1) Bălinişteanu B, Cîmpean AM, Ceauşu AR, Corlan AS, Melnic E, Raica M : High Ki-67 expression is associated with prolactin producing pituitary adenomas. Bosn J Basic Med Sci 17 : 104-108, 2017. – reference: 6) Jemel M, Kandara H, Riahi M, Gharbi R, Nagi S, Kamoun I : Gestational pituitary apoplexy : case series and review of the literature. J Gynecol Obstet Hum Reprod 48 : 873-881, 2019. – reference: 14) Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF : A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 331 : 904-909, 1994. – reference: 10) Piantanida E, Gallo D, Lombardi V, Tanda ML, Lai A, Ghezzi F, Minotto R, Tabano A, Cerati M, Azzolini C, Balbi S, Baruzzi F, Sessa F, Bartalena L : Pituitary apoplexy during pregnancy : a rare, but dangerous headache. J Endocrinol Invest 37 : 789-797, 2014. – reference: 9) 西岡 宏, 井下尚子 : 下垂体腫瘍の2017年WHO組織分類. No Shinkei Geka 47 : 597-606, 2019. – reference: 12) Stalldecker G, Mallea-Gil MS, Guitelman M, Alfieri A, Ballarino MC, Boero L, Chervin A, Danilowicz K, Diez S, Fainstein-Day P, García-Basavilbaso N, Glerean M, Gollan V, Katz D, Loto MG, Manavela M, Rogozinski AS, Servidio M, Vitale NM : Effect of cabergoline on pregnancy and embryo-fetal development : Retrospective study on 103 pregnancies and a review of the literature. Pituitary 13 : 345-350, 2010. – reference: 13) Wakai S, Fukushima T, Teramoto A, Sano K : Pituitary apoplexy : its incidence and clinical significance. J Neurosurg 55 : 187-193, 1981. – reference: 8) 成田善孝, 渋井壮一郎 : 脳腫瘍の治療結果を可視化する大規模データの収集・臨床試験の必要性―脳腫瘍全国集計調査報告の活用について―. 脳外誌 24 : 699-704, 2015. – reference: 3) Bronstein MD, Salgado LR, de Castro Musolino NR : Medical management of pituitary adenomas : the special case of management of the pregnant woman. Pituitary 5 : 99-107, 2002. – reference: 2) Barraud S, Guédra L, Delemer B, Raverot G, Ancelle D, Fèvre A, Jouanneau E, Litré CF, Wolak-Thierry A, Borson-Chazot F, Decoudier B : Evolution of macroprolactinomas during pregnancy : a cohort study of 85 pregnancies. Clin Endocrinol (Oxf) 92 : 421-427, 2020. – reference: 11) 藤森敬也, 佐藤 章 : 脳神経外科疾患合併妊娠―周産期専門医. 周産期医学 36 : 1085-1089, 2006. – reference: 5) Honegger J, Nasi-Kordhishti I, Aboutaha N, Giese S : Surgery for prolactinomas : a better choice? Pituitary 23 : 45-51, 2020. – reference: 7) Molitch ME : Endocrinology in pregnancy : management of the pregnant patient with a prolactinoma. Eur J Endocrinol 172 : R205-213, 2015. |
| SSID | ssj0003236073 ssib023160918 ssib002223908 ssib000937641 |
| Score | 2.2666845 |
| Snippet | プロラクチン産生下垂体腺腫に対してカベルゴリン (CAB) 内服加療中に妊娠した21歳女性. 妊娠判明後にCABは中止となった. 妊娠後期に両耳側半盲を認め, 高プロラクチン... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 146 |
| SubjectTerms | aggressive findings discontinuing CAB pituitary apoplexy sparsely granulated prolactin-producing pituitary adenoma third trimester pregnancy |
| Title | 妊娠後期に下垂体卒中を起こし緊急手術を必要としたプロラクチン産生下垂体腺腫の1例 |
| URI | https://www.jstage.jst.go.jp/article/jcns/30/2/30_146/_article/-char/ja |
| Volume | 30 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 脳神経外科ジャーナル, 2021, Vol.30(2), pp.146-151 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 2187-3100 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0003236073 issn: 0917-950X databaseCode: KQ8 dateStart: 20120101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LaxRBEB5CvHgRRcU3OdjHjTPT8-g-zmxmCYKCkEBuy7wW3EMUiR48OVlyMNFLEshFXEUMkRA9iCQIxh8zu8n-DKv6MTuKSMxlaKprqr-u6tmtqqnuMYzbPHbjJE2dBgRedsNhVtxIkiSDx506WIURJ-Jbh_fue7Pzzt0Fd2Fisl-rWnq6lEynz_-6r-Q0VgUa2BV3yf6HZSuhQIA22BeuYGG4nsjGJHJJ4BEWiAYjgYmNMCKsSSKP8CbhLRJR8BZJEJLIISEjLEQeDjy2oMwQTpHCoGErnmBG3GULCiMhyPSVHGSWDaD4SMfRPSyYCFzR4GIIEFIxSzkgpEWYK7o8lKCAsZpA2ZCYqaZQjQdf6SuBgeZRcigJKeLhDgl0A-X8Y8oMwYSBaqB-JJ7IEkzAHdY9d8HnqGECIQ7n7wpdw_0wnie6YGxLoQyZxk01yqbGHeiu6p1XTflguxkUA-ufRJxwjqDVuOaY3yOBLVQqUOBhx8jvI3jUFIgDY7hj_go4FyMzyQ-DiWWEUlqAoM4P1oQJoe08VKPgF2pioZoja2ob03oGyR7njsQIvloesCaD5ql0SWuGlhRTq1BDCHk982xh1YC5IF0QQQNHE9Plpln_Y1Yv7B7W8iPyX1ZnraXDZskTi__0BbBMFn2BFB5xak5X9_x2uLp6dNvI1aZm28aL2KevOnDvY7sLAdgZGxN-WPXxoBa_gHPv1eMJcLb5-LAsiJ08mC2rkr7Upp4pq160EuSeYQR7pwYV_OEuRIe6slQ4u3PnjXMqSp0KJLwLxkQ3vmg8G26vDnfeDQ9fHb3pl8Xu4GBt-HZ58GNj-Hp9cLBXLq-Pvu2XxUZZbB3vrx69-Hj0cm30fgPow58ro-2iLHagqyz6ZW-r7O2VvU_l8peyV5S9r8ebH443-5XA0cr30cpuWXy2Bodrl4z5VjTXnG2oz7Y0urC64Lc-o3ncwcDDZfhl-9zxE-qnGe04MU0g4rI6InLL8fDJjGc5zUzqJjSOWQdP76KXjcnFR4v5FWMKgkW7EzspnpLmpNTnKc9zrETNzCTpcH7V8KWa2o_l2Tztkxr02qnvvG6cxYdIpmFvGJNLT57mNyEwWUpuicXxCwtwAE8 |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E5%A6%8A%E5%A8%A0%E5%BE%8C%E6%9C%9F%E3%81%AB%E4%B8%8B%E5%9E%82%E4%BD%93%E5%8D%92%E4%B8%AD%E3%82%92%E8%B5%B7%E3%81%93%E3%81%97%E7%B7%8A%E6%80%A5%E6%89%8B%E8%A1%93%E3%82%92%E5%BF%85%E8%A6%81%E3%81%A8%E3%81%97%E3%81%9F%E3%83%97%E3%83%AD%E3%83%A9%E3%82%AF%E3%83%81%E3%83%B3%E7%94%A3%E7%94%9F%E4%B8%8B%E5%9E%82%E4%BD%93%E8%85%BA%E8%85%AB%E3%81%AE1%E4%BE%8B&rft.jtitle=%E8%84%B3%E7%A5%9E%E7%B5%8C%E5%A4%96%E7%A7%91%E3%82%B8%E3%83%A3%E3%83%BC%E3%83%8A%E3%83%AB&rft.au=%E4%B8%AD%E6%9D%91%2C+%E9%99%BD%E7%A5%90&rft.au=%E6%A2%85%E5%8C%97%2C+%E7%BE%A9%E4%B9%85&rft.au=%E7%A5%9E%E9%83%A8%2C+%E6%95%A6%E5%8F%B8&rft.au=%E7%89%A7%E5%B6%8B%2C+%E3%81%8B%E3%82%8C%E3%82%93&rft.date=2021&rft.pub=%E6%97%A5%E6%9C%AC%E8%84%B3%E7%A5%9E%E7%B5%8C%E5%A4%96%E7%A7%91%E3%82%B3%E3%83%B3%E3%82%B0%E3%83%AC%E3%82%B9&rft.issn=0917-950X&rft.eissn=2187-3100&rft.volume=30&rft.issue=2&rft.spage=146&rft.epage=151&rft_id=info:doi/10.7887%2Fjcns.30.146&rft.externalDocID=article_jcns_30_2_30_146_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0917-950X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0917-950X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0917-950X&client=summon |