Masui Katsuya, Yonezawa Taiji, Shinji Yukei, Nakano Ryo, Miyamae Seisuke
Department of Neurosurgery, Osaka Police Hospital.
Neurol Med Chir (Tokyo). 2013;53(10):695-8. doi: 10.2176/nmc.cr2012-0068. Epub 2013 Sep 27.
Melanoma metastases to the pituitary gland are extremely rare, with only a few reported cases. We report an unusual case of pituitary metastatic melanoma in which the patient presented with pituitary apoplexy. A 68-year-old man presented general fatigue and anorexia following sudden headache. Neurological examination disclosed bitemporal hemianopsia. Computed tomography (CT) scans revealed a suprasellar mass including intratumoral hematoma. Magnetic resonance (MR) images demonstrated a circumscribed mass lesion in the intra- and suprasellar regions, compressing the optic chiasm. Surgical exploration was performed through a transsphenoidal approach, and a mixture of tumor and necrotic tissue with old hematoma was obtained. The histological examination of the specimen revealed a partly necrotic, malignant tumor with focal melanotic pigmentation. Histopathologically, the diagnosis was consistent with pituitary apoplexy caused by hemorrhage from pituitary metastatic melanoma.
黑色素瘤转移至垂体极为罕见，仅有少数病例报道。我们报告一例不寻常的垂体转移性黑色素瘤病例，该患者表现为垂体卒中。一名68岁男性在突发头痛后出现全身乏力和厌食。神经系统检查发现双侧颞侧偏盲。计算机断层扫描（CT）显示鞍上肿块，包括瘤内血肿。磁共振（MR）图像显示鞍内和鞍上区域有一个边界清晰的肿块病变，压迫视交叉。通过经蝶窦入路进行手术探查，获取了肿瘤、坏死组织与陈旧性血肿的混合物。标本的组织学检查显示为部分坏死的恶性肿瘤，伴有局灶性黑色素沉着。组织病理学诊断为垂体转移性黑色素瘤出血导致的垂体卒中。
