Kong Xiangyi, Wu Huanwen, Ma Wenbin, Li Yongning, Yang Yi, Xing Bing, Wei Junji, Yao Yong, Gao Jun, Lian Wei, Xu Zhiqin, Dou Wanchen, Ren Zuyuan, Su Changbao, Wang Renzhi
From the Department of Neurosurgery (XK, WM, YL, YY, BX, JW, YY, JG, WL, ZX, WD, ZR, CS, RW); Department of Pathology (HW), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Medicine (Baltimore). 2016 Mar;95(9):e2931. doi: 10.1097/MD.0000000000002931.
In central nervous system, schwannomas, as ubiquitous tumors, mostly originate from sensory nerves like auditory and trigeminal nerves. However, intrasellar schwannomas are extremely rare. They are often misdiagnosed as pituitary adenomas. We report a rare case of schwannoma in the sellar region--a challenging diagnosis guided by clinical presentations, radiological signs, and postoperative pathological test. We represent a 65-year-old woman who had suffered from headaches, hypothyroidism, and visual disturbance. Her MRI revealed an abnormal sellar region mixed-signal mass lesion with suprasellar, left parasellar, and sellar floor invasiveness. We present detailed analysis of the patient's disease course and review relevant literatures. Written informed consent was obtained from the patient for publication of this article. A copy of the written consent is available for review by the editors of MEDICINE. Because this article does not involve any human or animal trials, there is no need to conduct special ethic review and the ethical approval is not necessary. When surgically treated, her specimen revealed a typical histopathology pattern of schwannoma. The patient's symptoms improved a lot after surgery and he continues to be under observation. Despite its rarity, intrasellar schwannoma should be considered in the differential diagnosis of sellar lesions that mimic pituitary adenomas.
在中枢神经系统中,神经鞘瘤作为常见肿瘤,大多起源于听神经和三叉神经等感觉神经。然而,鞍内神经鞘瘤极为罕见。它们常被误诊为垂体腺瘤。我们报告一例鞍区神经鞘瘤罕见病例——通过临床表现、影像学征象及术后病理检查进行具有挑战性的诊断。我们介绍一位65岁女性,她患有头痛、甲状腺功能减退和视力障碍。她的磁共振成像(MRI)显示鞍区有异常混合信号肿块病变,侵犯鞍上、左侧鞍旁及鞍底。我们对该患者的病程进行详细分析并复习相关文献。已获得患者的书面知情同意以发表本文。书面同意书副本可供《医学》杂志编辑查阅。由于本文不涉及任何人体或动物试验,无需进行特殊伦理审查,也无需伦理批准。手术治疗时,她的标本显示出典型的神经鞘瘤组织病理学模式。患者术后症状有很大改善,目前仍在接受观察。尽管鞍内神经鞘瘤罕见,但在鉴别诊断类似垂体腺瘤的鞍区病变时应予以考虑。