Arai Atsushi, Nishihara Masamitsu, Sasayama Takashi, Aihara Hideo, Hosoda Kohkichi, Itoh Tomoo, Sakagami Yoshio, Kuwamura Keiichi, Kohmura Eiji
Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Neurol Med Chir (Tokyo). 2010;50(6):488-91. doi: 10.2176/nmc.50.488.
A 55-year-old woman presented with a rare xanthogranuloma of the sellar region after complaining of severe headache and visual disturbance 3 months previously. Clinical examination showed she was alert with early signs of bitemporal hemianopsia. Endocrinological examination revealed hypopituitarism. Magnetic resonance imaging showed an intrasellar mass extending into the suprasellar region and compressing the optic chiasma, which appeared homogeneously hyperintense on T(1)-weighted images. Endonasal transsphenoidal resection of the tumor was performed. Histological examination disclosed granulomatous tissue with cholesterol clefts, hemosiderin deposits, fibrous tissues, and macrophages containing rich fat. The histological diagnosis was xanthogranuloma of the sellar region. Her visual symptoms recovered postoperatively although the hypopituitarism remained. Xanthogranuloma of the sellar region is rare, but must be considered in the differential diagnosis of tumors of the sellar region.
一名55岁女性,3个月前出现严重头痛和视觉障碍,随后被诊断为罕见的鞍区黄色肉芽肿。临床检查显示她意识清醒,有双颞侧偏盲的早期体征。内分泌检查发现垂体功能减退。磁共振成像显示鞍内肿块延伸至鞍上区域并压迫视交叉,在T(1)加权图像上呈均匀高信号。对该肿瘤进行了鼻内镜经蝶窦切除术。组织学检查发现肉芽肿组织伴有胆固醇裂隙、含铁血黄素沉积、纤维组织以及富含脂肪的巨噬细胞。组织学诊断为鞍区黄色肉芽肿。术后她的视觉症状有所恢复,尽管垂体功能减退仍然存在。鞍区黄色肉芽肿很罕见,但在鞍区肿瘤的鉴别诊断中必须予以考虑。