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免疫功能正常患者中模拟垂体肿瘤的原发性鞍区曲霉脓肿

Primary Aspergillus sellar abscess simulating pituitary tumor in immunocompetent patient.

作者信息

Ouyang Taohui, Zhang Na, Wang Long, Jiao Jiantong, Zhao Yiqing, Li Zheng, Chen Jian

机构信息

From the Departments of *Neurosurgery and †Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Craniofac Surg. 2015 Mar;26(2):e86-8. doi: 10.1097/SCS.0000000000001288.

Abstract

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.

摘要

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。

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