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孤立性鞍结节结核瘤伴全垂体功能减退:临床、诊断注意事项及文献复习。

Isolated sellar tuberculoma presenting with panhypopituitarism: clinical, diagnostic considerations and literature review.

机构信息

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, EPIP Area, Whitefield, Bangalore, 560066, Karnataka, India.

出版信息

Neurol Sci. 2011 Apr;32(2):301-4. doi: 10.1007/s10072-010-0409-z. Epub 2010 Oct 1.

Abstract

Tuberculosis, a common cause for chronic intracranial infections can mimic varied intracranial pathologies including tumours. Pituitary tuberculomas are rare lesions and are often diagnosed pre-operatively as pituitary tumours. We report a case of a 31-year-old lady with a sellar-suprasellar lesion who presented with panhypopituitarism. The patient underwent a trans-nasal, trans-sphenoidal surgical decompression of the lesion. Histopathology revealed a tuberculous lesion in the pituitary. The characteristic radiological features of sellar tuberculomas are discussed along with a review of literature. Atypical sellar radiology in the presence of a thickened pituitary stalk could point to pathology other than pituitary adenoma, possibly a chronic inflammatory condition like tuberculoma.

摘要

结核病是一种常见的慢性颅内感染病因,可以模仿包括肿瘤在内的各种颅内病变。垂体结核瘤是罕见的病变,通常在术前被诊断为垂体肿瘤。我们报告了一例 31 岁女性,有鞍上-鞍旁病变,表现为全垂体功能减退。患者接受了经鼻经蝶窦手术减压病变。组织病理学显示垂体中有结核病变。讨论了鞍内结核瘤的典型影像学特征,并复习了文献。在垂体柄增厚的情况下出现非典型鞍部影像学可能提示除垂体腺瘤以外的其他病理,可能是慢性炎症性疾病如结核瘤。

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