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首页> 外文期刊>Neurosurgical focus >Harvey Cushing and pituitary Case Number 3 (Mary D.): the origin of this most baffling problem in neurosurgery
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Harvey Cushing and pituitary Case Number 3 (Mary D.): the origin of this most baffling problem in neurosurgery

机译：Harvey Cushing和垂体案例3（玛丽D.）：神经外科最令人困惑的问题的起源

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From the very beginning of his career, Harvey Williams Cushing (1869-1939) harbored a deep interest in a complex group of neoplasms that usually developed at the infundibulum. These were initially known as "interpeduncular" or "suprasellar" cysts. Cushing introduced the term "craniopharyngioma" for these lesions, which he believed represented one of the most baffling problems faced by neurosurgeons. The patient who most influenced Cushing's thinking was a 16-year-old seamstress named "Mary D.," whom he attended in December 1901, exactly the same month that Alfred Frohlich published his seminal article describing an adiposogenital syndrome in a young boy with a pituitary cyst. Both Cushing's and Frohlich's patients showed similar symptoms caused by the same type of tumor. Notably, Cushing and Frohlich had met one another and became good friends in Liverpool the summer before these events took place. Their fortunate relationship led Cushing to realize that Frohlich's syndrome represented a state of hypopituitarism and provided a useful method of diagnosing interpeduncular cysts. It is noteworthy that Cushing's very first neurosurgical procedure on a pituitary tumor was performed in the case of Mary D.'s " interpeduncular cyst," on February 21, 1902. Cushing failed to remove this lesion, which was later found during the patient's autopsy. This case was documented as Pituitary Case Number 3 in Cushing's masterpiece, The Pituitary Body and Its Disorders, published in 1912. This tumor was considered "a teratoma"; however, multiple sources of evidence suggest that this lesion actually corresponded to an adamantinomatous craniopharyngioma. Unfortunately, the pathological specimens of this lesion were misplaced, and this prompted Cushing's decision to retain all specimens and documents of the cases he would operate on throughout his career. Accordingly, Mary D.'s case crystallized the genesis of the Cushing Brain Tumor Registry, one of Cushing's major legacies to neurosurgery. In this paper the authors analyze the case of Mary D. and the great influence it had on Cushing's conceptions of the pituitary gland and its afflictions, and on the history of pituitary surgery.
机译：从他的职业生涯的一开始，Harvey Williams Cushing（1869-1939）在一群通常在Infunculum开发的复杂肿瘤组中受到深深的兴趣。这些初始被称为“局部局部”或“Suprasellar”囊肿。 Cushing引入了这些病变的“颅咽管瘤”术语，他认为神经外科医生面临的最令人困惑的问题之一。受影响最大的思想的患者是一名16岁的女裁缝，他于1901年12月出席的是“玛丽D”的裁缝，谁在同一个月份的同月，阿尔弗雷德弗里希·阿尔弗雷希公布了他的初创文章，描述了一个年轻男孩的adipoSenalital综合征。垂体囊肿。 Cushing的和Frohlich的患者均显示出由相同类型的肿瘤引起的类似症状。值得注意的是，CuShing和Frohlich彼此遇到了夏天在利物浦在这些活动发生之前成为了好朋友。他们幸运的关系LED Cushing意识到Frohlich的综合征代表了一种低钙症主义状态，并提供了一种诊断局部囊肿的有用方法。值得注意的是，在1902年2月21日的玛丽D.的“脑干囊肿”的情况下，缓解垂体肿瘤的第一个神经外科手术是在玛丽D.的“流通囊肿”的情况下进行的。缓冲未能去除这种病变，后来在患者的尸检期间发现。本案件被记录为缓冲件垂体案例3，在1912年发表的垂体件，垂体身体及其疾病中。这种肿瘤被认为是“畸胎瘤”;然而，多种证据来源表明，这种病变实际上与腺嘌呤颅骨瘤瘤相对应。不幸的是，这种病变的病理标本被放错了，而这种促使的Cushing决定保留他将在整个职业生涯中运作的所有标本和文件。因此，玛丽D.的案例结晶了缓冲脑肿瘤登记处的成因，这是一种库欣的神经外科的主要遗产之一。在本文中，作者分析了玛丽D的案例。以及对垂体垂体腺体的概念及其痛苦以及垂体手术的历史来说，它的巨大影响力。

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