Terao T, Sawauchi S, Hashimoto T, Miyazaki Y, Akiba Y, Abe T
Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-city, Chiba 277-8567, Japan.
No Shinkei Geka. 2001 Aug;29(8):755-8.
The author reported a case of a spontaneous rupture of a suprasellar cystic tumor. A 67-year-old man complained of bitemporal homonymous hemianopsia. His visual acuity was 0.02 on the right side and 0.04 on the left side. Skull XP revealed no abnormal findings, but brain CT scan showed a cystic mass without calcification in the suprasellar region. Brain MRI at the same lesion site depicted a low-intensity mass on T1-weighted image without gadolinium enhancement, and a high-intensity mass on T2-weighted image. The patient was treated conservatively because of complications such as diabetes mellitus, cerebral infarction and old myocardiac infarction. MRI taken 5 years after the initial MRI revealed disappearance of the suprasellar cystic mass. However, the patient's neurological findings, including visual signs, revealed no deterioration. His physical and radiological findings had remained uneventful. In this report, we reviewed the literatures about spontaneous rupture of suprasellar cystic tumors. It was considered that in this case, according to the neurological, radiological and CSF findings, the suprasellar cystic mass might be a Rathke's cleft cyst or arachnoid cyst.
作者报告了一例鞍上囊性肿瘤自发性破裂的病例。一名67岁男性主诉双侧颞侧同向性偏盲。其右眼视力为0.02,左眼视力为0.04。头颅X线平片未发现异常,但脑部CT扫描显示鞍上区域有一个无钙化的囊性肿块。同一病变部位的脑部MRI在T1加权图像上显示为低强度肿块,无钆增强,在T2加权图像上显示为高强度肿块。由于患者存在糖尿病、脑梗死和陈旧性心肌梗死等并发症,故采取保守治疗。初次MRI检查5年后的MRI显示鞍上囊性肿块消失。然而,患者的神经学表现,包括视觉症状,并未恶化。其身体和影像学检查结果一直平稳。在本报告中,我们回顾了有关鞍上囊性肿瘤自发性破裂的文献。根据该病例的神经学、影像学和脑脊液检查结果,认为鞍上囊性肿块可能是拉克氏裂囊肿或蛛网膜囊肿。