■分化型甲状腺癌(DTC)的垂体转移(PM)极为罕见,可能会对预后产生不利影响。我们旨在评估DTCPM患者的特征和预后。
■我们系统地回顾了有关PM和不同DTC组织学类型(乳头状,卵泡,和Hurthle细胞癌)。三个数据库(PubMed,Embase,和Scopus)搜索1967年至2022年发表的文章。生存时间估计为从PM的第一次治疗到死亡或最后一次随访的时间。
■使用系统审查和荟萃分析(PRISMA)的首选报告项目确定了25篇文章,包括27例符合资格标准的病例。患者的中位年龄为60岁(23-86岁)。大多数女性(66.7%)患有PM,最常报告乳头状甲状腺癌(55.6%)。其次是滤泡性甲状腺癌(37.0%)和Hurthle细胞癌(7.4%)。最常见的演讲是头痛,恶心,呕吐,有视觉症状者占44.4%。尿崩症是罕见的发现(7.4%)。从诊断或首次治疗DTC到诊断PM的中位时间为3年(0-25)。最常见的内分泌异常是高泌乳素血症(63.2%),而最常见的缺乏激素是黄体生成素(50%)。PM最常见的治疗方式是放疗和手术的结合,有或没有放射性碘。在后续行动结束时,30%的患者死亡。只有33.3%的患者实现了症状的完全缓解。总体中位生存时间为12个月(3-108)。患者年龄与生存率之间存在中度负相关,那是,然而,无统计学意义(rs=-0.45,P=0.103)。
■来自DTC的PM极为罕见,而Hurtle细胞癌似乎与PM的相关性最小。尿崩症是来自DTC的PM的罕见初始表现。在DTC的PM中不太可能实现症状的完全缓解。年龄较大可能会增加生存趋势,可能是由于与年轻人相比,老年人的颅内空间体积更大。需要进行更大规模的研究来检查DTC的年龄与PM生存率之间的关系。此外,需要更多的观察性数据来确定生存预测因子,并比较不同治疗方式对DTC的PM患者的疗效.
UNASSIGNED: Pituitary metastasis (PM) from differentiated thyroid cancer (DTC) is extremely rare and may adversely affect outcomes. We aimed to assess the characteristics and outcomes of patients with PM from DTC.
UNASSIGNED: We systematically reviewed the literature on publications on PM and the different DTC histologic types (papillary, follicular, and Hurthle cell cancers). Three databases (PubMed, Embase, and Scopus) were searched for articles published from 1967 to 2022. Survival time was estimated as the period from the first treatment of PM to the time of death or last follow-up.
UNASSIGNED: Twenty-five articles comprising 27 cases that met the eligibility criteria were identified using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The median age of the patients was 60 years (23 - 86). A preponderance of females (66.7%) with PM most commonly reported papillary thyroid cancer (55.6%). This was followed by follicular thyroid cancer (37.0%) and Hurthle cell cancer (7.4%). The most common presentations were headache, nausea, and vomiting, with visual symptoms in 44.4%. Diabetes insipidus was an infrequent finding (7.4%). The median time from diagnosis or first treatment of DTC to the diagnosis of PM was 3 years (0 - 25). The most common endocrine abnormality was hyperprolactinemia (63.2%), while the most frequently deficient hormone was luteinizing hormone (50%). The most common treatment modality for PM was a combination of radiotherapy and surgery with or without radio-iodine. At the end of the follow-up, 30% of the patients died. Only 33.3% of the patients achieved complete resolution of symptoms. The overall median survival time was 12 months (3 - 108). There was a moderate inverse correlation between the age of patients and survival, which was, however, not statistically significant (rs = -0.45, P = 0.103).
UNASSIGNED: PM from DTC is extremely rare, and Hurtle cell cancer appears to be the least associated with PM. Diabetes insipidus is a rare initial manifestation of PM from DTC. Complete resolution of symptoms is less likely to be achieved in PM from DTC. Older age may confer an increased survival tendency, probably due to more intracranial space volume in older people compared to the younger population. Larger studies are needed to examine the relationship between age and survival in PM from DTC. Also, more observational data are required to determine the predictors of survival and compare the efficacy of the different treatment modalities in patients with PM from DTC.