Hojo Masato, Ishibashi Ryota, Arai Hiroshi, Miyamoto Susumu
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
Asian J Neurosurg. 2017 Apr-Jun;12(2):283-286. doi: 10.4103/1793-5482.146390.
We report a case of granulomatous hypophysitis caused by Rathke's cleft cyst (RCC) mimicking a growth hormone (GH)-secreting pituitary adenoma. Neuroradiological and endocrinological evaluations showed abnormal findings consistent with acromegaly: Magnetic resonance imaging demonstrated a pituitary mass lesion, and GH and insulin-like growth factor I levels were markedly elevated, and GH levels were not suppressed in oral glucose tolerance test. Transsphenoidal surgery was performed, but no adenomatous tissue could be detected. Histological examination revealed RCC and concurrent granulomatous giant cell inflammatory reaction of the anterior hypophysis. To the authors' knowledge, this is the first documented case of granulomatous hypophysitis caused by RCC mimicking a GH-secreting pituitary adenoma.
我们报告一例由拉克氏囊肿（RCC）引起的肉芽肿性垂体炎，其表现类似分泌生长激素（GH）的垂体腺瘤。神经放射学和内分泌学评估显示与肢端肥大症相符的异常结果：磁共振成像显示垂体有占位性病变，GH和胰岛素样生长因子I水平显著升高，口服葡萄糖耐量试验中GH水平未被抑制。进行了经蝶窦手术，但未检测到腺瘤组织。组织学检查显示为RCC以及垂体前叶并发的肉芽肿性巨细胞炎症反应。据作者所知，这是首例有文献记载的由RCC引起的肉芽肿性垂体炎，表现类似分泌GH的垂体腺瘤。
