Fujimoto Yasunori, Matsushita Hamilton, Velasco Octávio, Rosemberg Sérgio, Plese José Píndaro, Marino Raul
Divisions of Neurosurgery and Pathology, University of São Paulo Medical School, São Paulo, Brazil.
Pediatr Neurosurg. 2002 Oct;37(4):210-6. doi: 10.1159/000065396.
Craniopharyngiomas are most commonly located in the intradural suprasellar region. However, ectopic craniopharyngiomas can originate in the infrasellar region. The authors present the case of an 8-year-old boy diagnosed with a large cystic craniopharyngioma involving the nasal cavities and maxillary, ethmoid and sphenoid sinuses, in addition to the sella turcica. The primary symptoms of this patient were nasal obstruction, unilateral decreased visual acuity and exophthalmos. He subsequently underwent combined radical resection of the tumor by means of an endonasal transsphenoidal approach followed by radiation therapy. During the surgery, the dura mater of the sellar floor was found to be intact. The neuroradiological and surgical findings suggested that this tumor originated in the extradural infrasellar region and invaded the sella turcica.
颅咽管瘤最常位于硬脑膜内鞍上区域。然而,异位颅咽管瘤可起源于鞍下区域。作者报告了一例8岁男孩的病例,该男孩被诊断为巨大囊性颅咽管瘤,除蝶鞍外,还累及鼻腔、上颌窦、筛窦和蝶窦。该患者的主要症状为鼻塞、单眼视力下降和眼球突出。随后,他通过鼻内镜经蝶窦入路进行了肿瘤根治性联合切除术,术后接受了放射治疗。手术过程中,发现蝶鞍底部的硬脑膜完整。神经放射学和手术结果表明,该肿瘤起源于硬脑膜外鞍下区域并侵犯了蝶鞍。