Bangash M H, Clarke D B, Holness R O
Department of Surgery (Neurosurgery), Dalhousie University, Halifax, Nova Scotia, Canada.
Can J Neurol Sci. 2006 May;33(2):240-2. doi: 10.1017/s0317167100005060.
Dopamine agonists are widely used in the treatment of pituitary prolactinomas. We report a case of inferior mesial frontal lobe (gyrus rectus) and chiasmal herniations into an enlarged sella following successful medical treatment of a pituitary macroadenoma.
A 71-year-old healthy man presented to medical attention with visual complaints. On examination, he was found to have bitemporal hemianopsia. Endocrine evaluation revealed an elevated prolactin level. He was treated medically with a dopamine agonist (bromocriptine).
Evaluation after one year of medical treatment revealed stabilization of the patient's vision, with a significant bitemporal field loss. Serum prolactin levels normalized (5.16 ng/ml). The MRI of the sella showed almost complete disappearance of the tumor, resulting in right mesial frontal lobe herniation inferiorly into an enlarged sella with associated chiasmal deformation.
We report a case where successful medical treatment of a large pituitary prolactinoma has resulted in inferior frontal lobe and chiasmal herniatons into an enlarged sella.
多巴胺激动剂广泛应用于垂体泌乳素瘤的治疗。我们报告一例垂体大腺瘤经成功药物治疗后，内侧额叶下部（直回）和视交叉疝入扩大的蝶鞍的病例。
一名71岁健康男性因视力问题就医。检查发现他有双颞侧偏盲。内分泌评估显示泌乳素水平升高。他接受了多巴胺激动剂（溴隐亭）的药物治疗。
药物治疗一年后的评估显示患者视力稳定，但仍有明显的双颞侧视野缺损。血清泌乳素水平恢复正常（5.16 ng/ml）。蝶鞍的磁共振成像显示肿瘤几乎完全消失，导致右侧内侧额叶下部疝入扩大的蝶鞍，并伴有视交叉变形。
我们报告了一例大型垂体泌乳素瘤经成功药物治疗后导致额叶下部和视交叉疝入扩大蝶鞍的病例。
