Larrañaga J, Fandiño J, Gomez-Bueno J, Rodriguez D, Gonzalez-Carrero J, Botana C
Service of Neurosurgery, Hospital General, Vigo, Spain.
Neuroradiology. 1989;31(4):362-3. doi: 10.1007/BF00344187.
Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimicked a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia.
蝶窦曲霉菌病是蝶鞍扩大的一种罕见病因。曾有曲霉菌继发垂体脓肿的报道。在本病例中,一名患有蝶窦曲霉菌病的女性表现类似垂体肿瘤。该患者经蝶窦入路感染后存活,垂体功能完好。术后无需使用两性霉素B和5-氟胞嘧啶。CT扫描显示蝶窦有占位性病变并延伸至蝶鞍。对于蝶鞍扩大的患者,应警惕蝶窦和垂体脓肿存在的因素包括既往鼻窦炎、脑膜炎病史、免疫抑制,以及本病例中的高血糖。