Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA.
BMC Ophthalmol. 2011 Jan 27;11:4. doi: 10.1186/1471-2415-11-4.
Pituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy.
A 44 year old female with a history of sarcoidosis presented with an isolated sixth cranial nerve palsy as the initial clinical feature of a rapidly expanding ACTH positive silent pituitary adenoma. The patient underwent emergent transsphenoidal hypophysectomy for this rapidly progressive tumor and subsequently regained complete vision and ocular motility. Despite tumor extension into the cavernous sinus, the other cranial nerves were spared during the initial presentation.
This case illustrates the need to consider a rapidly growing pituitary tumor as a possibility when presented with a rapidly progressive ophthalmoplegia.
垂体腺瘤可能表现为神经眼科症状，通常情况下，肿瘤的快速扩张是由于卒中引起的。在此，我们报告首例孤立性第六颅神经麻痹作为无卒中的快速扩张 ACTH 阳性垂体腺瘤的首发特征。
一位 44 岁的女性患者，有结节病病史，以孤立性第六颅神经麻痹为首发症状，表现为快速扩张的 ACTH 阳性垂体腺瘤。患者因这种快速进展的肿瘤而紧急接受了经蝶窦垂体切除术，随后完全恢复了视力和眼球运动。尽管肿瘤向海绵窦扩展，但在最初表现时其他颅神经未受累。
当出现快速进展性眼肌麻痹时，需要考虑迅速生长的垂体瘤的可能性。
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