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[一例老年颅咽管瘤病例:有限手术及放射治疗]

[An elderly case of craniopharyngioma: treatment by limited surgery and radiation therapy].

作者信息

Sato Atsushi, Sakurada Kaori, Kokubo Yasuaki, Sato Shinya, Kayama Takamasa

机构信息

Department of Neurosurgery, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.

出版信息

No Shinkei Geka. 2005 Dec;33(12):1183-9.

Abstract

Craniopharyngioma accounts for approximately 3.5% of all intracranial neoplasm and may occur at any age. However craniopharyngioma in the elderly was rare. We report a rare case of craniopharyngioma in an elderly patient, who was treated by radical surgery successfully. An 80-year-old male was admitted to our hospital with a history of visual disturbance and bitemporal hemianopsia. CT scan of the brain revealed a hypodense cystic mass with calcification in the suprasellar area. MRI demonstrated the optic chiasm was displaced superiorly. Her symptom deteriorated day short time of her hospitalized life. We decided to removal tumor radically because of saving her visual function. Subtotal removal of the suprasellar lesion was performed, followed by radiotherapy to the residual lesion. A visual impairment was improved after surgery. No recurrences had been detected on MRI eighteen months after the initial operation. Based on previous report and the clinical course of our case, radical surgery is sometimes needed for saving visual function in spite of elderly patient. However, in this case, sparing hypothalamic and pituitary function is essential for good prognosis.

摘要

颅咽管瘤约占所有颅内肿瘤的3.5%,可发生于任何年龄。然而,老年患者的颅咽管瘤较为罕见。我们报告一例老年颅咽管瘤患者的罕见病例,该患者成功接受了根治性手术。一名80岁男性因视力障碍和双颞侧偏盲病史入院。脑部CT扫描显示鞍上区有一个低密度囊性肿块伴钙化。MRI显示视交叉向上移位。在她住院后的短时间内症状恶化。为挽救其视力功能,我们决定进行根治性肿瘤切除。对鞍上病变进行了次全切除,随后对残留病变进行了放疗。术后视力障碍有所改善。初次手术后18个月的MRI检查未发现复发。根据既往报道及我们病例的临床过程,尽管患者为老年人,但有时为挽救视力功能仍需进行根治性手术。然而,在本病例中,保留下丘脑和垂体功能对良好预后至关重要。

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