Ouyang Taohui, Zhang Na, Wang Long, Jiao Jiantong, Zhao Yiqing, Li Zheng, Chen Jian
From the Departments of *Neurosurgery and †Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
J Craniofac Surg. 2015 Mar;26(2):e86-8. doi: 10.1097/SCS.0000000000001288.
A 55-year-old woman presented with headache, dizziness, and decreased visual acuity. Magnetic resonance imaging revealed a sellar mass with sphenoid sinus extension. The result of hormone showed an obviously high prolactin (815 ng/mL). The mass was resected and diagnosed with aspergillosis pathologically. Postoperatively, the level of prolactin dramatically decreased, and the patient received medical treatment with voriconazole and caspofungin. During a 6-month follow-up, the patient's headache and dizziness disappeared, and visual acuity improved. Therefore, aspergillus sellar abscess could result in hyperprolactinemia and should be considered in the differential diagnosis of a sellar mass, even in immunocompetent patients. A combination of surgery and antifungal therapy could reduce the hyperprolactinemia and improve symptoms.
一名55岁女性出现头痛、头晕和视力下降。磁共振成像显示蝶鞍区有肿块并向蝶窦延伸。激素检查结果显示催乳素明显升高(815 ng/mL)。该肿块被切除,病理诊断为曲霉病。术后,催乳素水平显著下降,患者接受了伏立康唑和卡泊芬净治疗。在6个月的随访中,患者的头痛和头晕消失,视力改善。因此,蝶鞍曲霉脓肿可导致高催乳素血症,即使在免疫功能正常的患者中,在蝶鞍区肿块的鉴别诊断中也应考虑该病。手术和抗真菌治疗相结合可降低高催乳素血症并改善症状。