Sareen Pooja, Chhabra Lovely, Trivedi Nitin
Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
BMJ Case Rep. 2013 May 27;2013:bcr2013009934. doi: 10.1136/bcr-2013-009934.
Sellar tumours in adults are most commonly pituitary adenomas. Primary spindle cell sarcoma of the sella turcica without a prior history of cranial radiation is extremely rare. We report a case of a large sellar mass with suprasellar and cavernous sinus extension in a geriatric male patient who presented with complete left oculomotor nerve palsy and panhypopituitarism. The patient underwent partial resection of the sellar mass through transcranial route. The pathology of the mass revealed a poorly differentiated spindle cell neoplasm most consistent with a sarcoma. Postoperatively, the size of the residual sellar mass decreased significantly following six cycles of external beam radiation in conjunction with temozolomide.
成人鞍区肿瘤最常见的是垂体腺瘤。既往无颅脑放疗史的蝶鞍原发性梭形细胞肉瘤极为罕见。我们报告一例老年男性患者，其鞍区有一巨大肿块并向鞍上和海绵窦延伸，表现为完全性左侧动眼神经麻痹和全垂体功能减退。患者通过经颅途径接受了鞍区肿块部分切除术。肿块病理显示为低分化梭形细胞瘤，最符合肉瘤。术后，在接受六个周期的外照射放疗联合替莫唑胺治疗后，残余鞍区肿块大小显著减小。
