Qiu Lubin, Zhu Yongjun, Wang Haijun, Wang Yatang, Wu Qiang, Yang Jianming
Department of Otorhinolaryngology, the Second Hospital of Anhui Medical University Hefei People's Republic of China.
Department of Neurosurgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou People's Republic of China.
Neuroophthalmology. 2013 Nov 19;37(6):231-238. doi: 10.3109/01658107.2013.830626. eCollection 2013.
A 63-year-old man presented with sexual dysfunction of 6-year duration, 5-year history of bilateral vision loss, and left nasal obstruction for 3 years. Brain computed tomography and magnetic resonance imaging showed a large mass lesion in the saddle area and extending upward to the dorsum sellae, bilateral cavernous sinus, and suprasellar region, and down into the sphenoid sinus and nasal cavity; the optic nerves and optic chiasm were elevated upward and compressed. Endocrine tests indicated that all serum level of anterior pituitary hormones decreased. The preoperative diagnosis included invasive pituitary adenoma, chordoma, osteosarcoma, chondrosarcoma, and craniopharyngioma. The tumour was subtotally removed through transsphenoidal approach. Histopathology examination revealed a chondroma. Postoperatively, the patient was stable and his visual acuity and visual field defect improved and his pituitary function return to normal except for hypothyroidism.
一名63岁男性,有6年性功能障碍病史、5年双眼视力丧失病史以及3年左侧鼻塞病史。脑部计算机断层扫描和磁共振成像显示鞍区有一巨大肿块,向上延伸至鞍背、双侧海绵窦和鞍上区域,向下延伸至蝶窦和鼻腔;视神经和视交叉向上抬高并受压。内分泌检查表明所有垂体前叶激素血清水平均下降。术前诊断包括侵袭性垂体腺瘤、脊索瘤、骨肉瘤、软骨肉瘤和颅咽管瘤。通过经蝶窦入路对肿瘤进行了次全切除。组织病理学检查显示为软骨瘤。术后患者病情稳定,视力和视野缺损有所改善,除甲状腺功能减退外垂体功能恢复正常。