Hata Nobuhiro, Inoue Tooru, Katsuta Toshiro, Iwaki Toru
Department of Neurosurgery, Clinical Research Institute, National Kyushu Medical Center Hospital, Fukuoka, Japan.
Neurol Med Chir (Tokyo). 2003 Aug;43(8):399-403. doi: 10.2176/nmc.43.399.
A 24-year-old woman presented with a rare adrenocorticotropic hormone (ACTH)-positive pituitary adenoma in the cavernous sinus, manifesting as sudden onset of oculomotor nerve paresis. Neuroimaging revealed a tumor in the cavernous sinus bulging into the subdural space. There was no continuity between the tumor and the pituitary gland in the sella turcica. Gross total removal of the tumor was performed through the orbitozygomatic approach followed by stereotactic radiosurgery. The oculomotor nerve paresis was resolved. Histological examination revealed an adenoma positive for ACTH. Ectopic pituitary adenoma occurs mostly in the sphenoid sinus or the suprasellar region. This extremely rare case of ectopic macroadenoma in the cavernous sinus manifested as oculomotor nerve paresis without signs of Cushing's syndrome.
一名24岁女性因海绵窦内罕见的促肾上腺皮质激素（ACTH）阳性垂体腺瘤就诊，表现为动眼神经麻痹突然发作。神经影像学检查显示海绵窦内有一肿瘤突入硬膜下间隙。肿瘤与蝶鞍内的垂体无连续性。通过眶颧入路行肿瘤全切除，随后进行立体定向放射外科治疗。动眼神经麻痹得以缓解。组织学检查显示为ACTH阳性腺瘤。异位垂体腺瘤多发生于蝶窦或鞍上区域。这例海绵窦内极为罕见的异位大腺瘤表现为动眼神经麻痹，无库欣综合征体征。
