No one believes that the fat man in front of him, who looks like a blown balloon, is the same young man on the ID card. In the end, what is the disease, so that the 36-year-old boy "face completely different"? The original problem in the brain! After the Fudan University Affiliated Huashan Hospital multidisciplinary treatment, and now small stone has been "transformed" completely healed.
The fatal obesity is actually Cushing's syndrome
From 2016 onwards, Xiaoshi was obviously "fat": he thought that people over thirty "pressure fat", but no matter how diet and exercise are useless, his blood pressure is also out of control at the same time. At the beginning of this year, ordinary antihypertensive drugs have been completely unable to control his blood pressure, but also a variety of discomforts: blurred vision, lethargy, double the amount of food every day to feel hungry, drink at least five liters of water before barely addicted to the small stone determined to go to the local hospital.
The results were a surprise: doctors suspected that his symptoms were caused by Cushing's syndrome. This rare disease is caused by the body's excessive secretion of glucocorticoids, causing electrolyte disorders and metabolic disorders of proteins, sugars and fats, which lead to a series of symptoms that are "all over the place".
It is reported that Cushing's syndrome, also known as "cortisolism", the early manifestations of obesity, hypertension, diabetes, etc., is very easy to be misdiagnosed, and once untreated, within a few years will involve the whole body of multiple organs and systems, resulting in serious harm: full-moon face, buffalo back, centripetal obesity; diabetes; hypertension, atherosclerosis, heart failure; skin purplish, and the skin is very thin, and the skin is very thin. Sclerosis, heart failure; skin purple lines, muscle atrophy, osteoporosis, bone fracture; lowered immunity leading to a variety of infections; female amenorrhea, infertility, male function decline, infertility; emotional instability, psychopathology, depression and mania alternating, insomnia, memory loss ...... can be said to have no place in the whole body is normal, and the mortality rate is four times that of the normal population. Hearing the results, 36-year-old Xiao Shi and his family were confused.
"The culprit" is as small as a soybean hidden in the pituitary gland
Recommended by the local doctor, Xiaoshi came to Shanghai to consult the famous pituitary tumor clinical diagnosis and treatment center - Huashan Hospital affiliated with Fudan University. The "Golden Pituitary" multidisciplinary integration diagnosis and treatment center.
Professor Ye Hongying, deputy director of the Department of Endocrinology, explains: Cushing's syndrome is a difficult clinical condition with a complex etiology, which requires a rigorous endocrine evaluation and imaging to identify the cause of the disease before treatment can be targeted. She further elaborated that if the lesion is in the adrenal gland, it can basically be cured by surgical removal of the lesion; if the lesion is not of adrenal origin, further functional tests and imaging tests are needed to clarify whether the lesion originates from the pituitary gland.
Step by step, through the "gold standard" bilateral inferior petrous sinus vein blood sampling (BIPSS) examination, it is clear that Xiaoshi's cortisolism is indeed caused by the pituitary gland located in the deep part of the brain, and the lesion is located in the left side of the pituitary gland. The left side of the pituitary gland.
The pituitary gland, which is as small as a soybean and weighs only 3 grams, is located in the saddle region in the deep center of the brain, and it is the "commanding general" in charge of the neurological-endocrine system. Once a tumor secreting corticotropin (ACTH) grows, it will constantly stimulate the adrenal cortex to proliferate and secrete too much cortisol. Big names in the field of pituitary tumor treatment from neurosurgery, endocrinology, radiology and many other disciplines in China were invited to participate in the discussion, and the experts finally reached a unanimous agreement: Xiao Shi's condition is considered to be a pituitary ACTH tumor, or Cushing's disease, which is preferred to be treated with endoscopic surgery.
"Patients often have only one chance to undergo surgery."
In mid-July this year, Xiaoshi was admitted to the multidisciplinary "Huashan-Golden Pituitary" ward in Hongqiao Hospital. Led by academician Zhou Liangfu, director of neurosurgery at Huashan Hospital, the ward is the first truly multidisciplinary pituitary ward in the world, integrating more than a dozen disciplines, including neurosurgery and endocrinology pituitary subspecialties, with the most authoritative experts in pituitary disease treatment and the most advanced instruments and equipment.
Professor Zhao Yao, vice president of Hongqiao Campus of Huashan Hospital and head of "Huashan-Golden Pituitary" diagnosis and treatment center, said that compared with other types of pituitary tumors (such as prolactinomas and acromegaly), Cushing's disease is "the most intractable": it is small, hidden, and tricky. It is small, hidden, and tricky. Tumors are often only a few millimeters, sometimes in the magnetic **** vibration film can not be found, intraoperative in the pituitary gland to repeatedly explore. It also likes to grow against the walls of large arteries and blood vessels, which can lead to fatal hemorrhaging.
The toughest challenge in dealing with these pituitary tumors is that once the tumor is not completely removed in the first surgery, even if only a "tiny bit" is left behind, the patient's symptoms will quickly return. Reoperation is extremely difficult to find the small pieces of tumor left over from the first surgery due to the large amount of scar tissue in the surgical area. "Patients often only have this one chance for surgery." Prof. Zhao said.
On July 17, Professor Zhao Yao performed endoscopic-assisted transnasal minimally invasive pituitary tumor resection for Xiao Shi. Using advanced endoscopic equipment, the surgeon entered from the center of the nose, opened the saddle bottom, and saw a small grayish-white tumor on the left side of the pituitary gland, which was close to the blood vessel wall, and carefully removed it. The surgical team repeatedly explored all parts of the pituitary gland to make sure none of the tumor remained before concluding the surgery. Postoperative measurements showed that the tumor was only about 0.5 cm in diameter.
The miracle of the "transformation" took place!
On the first day after the operation, Xiaoshi said, "It's so hard, it's like I'm going to faint. The doctor was very happy to hear that the patient had been in a state of cortisol surge for a long time before the operation; after the tumor was cut cleanly, the blood cortisol level fell to the "bottom", and the body was extremely uncomfortable. This is a sign of improvement, as if the "dead and alive".
The specialized endocrinology team in the fusion ward followed up with follow-up treatment. In just a few days, a series of miraculous changes took place in Xiaoshi's body: his fat face, like a full moon, became smaller and thinner day by day; his skin gradually became smooth and fair from the original rough reddish-brown color; and on the next day after the operation, his blood pressure went back to normal on its own, and his hyperglycemia also disappeared. The next day after the operation, the blood pressure returned to normal, and the high blood sugar disappeared. No longer "gluttonous", just seven days after the operation, the weight loss of 12 pounds, and the self-consciousness of the whole body is incredibly easy!
Professor Zhao Yao said that the treatment effect of Cushing's disease is immediate, the tumor is clean, the endocrine-related indicators immediately alleviated, and the symptoms quickly disappear; on the other hand, it means that it is not clean. Therefore, the endocrine index relief is "the only test of truth". At present, the international Cushing's disease surgical remission rate is about 70% to 85%, Huashan Hospital 2019 pituitary tumor fusion ward admitted patients with Cushing's disease, surgical endocrine remission rate >90%."
A few days ago, "transformed" Xiaoshi once again into the "Huashan-Jin pituitary" multidisciplinary fusion ward to follow-up. The first thing you need to do is to get your hands on a new one," he said! So you're really as handsome as you look in the picture!" Seeing the physical appearance and appearance have been restored to normal Shi, ward medical staff can not help but joke, but also from the heart for him to be happy.