Pan Yuan-Bo, Sun Zhao-Liang, Feng Dong-Fu
Department of Neurosurgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Department of Neurosurgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
J Clin Neurosci. 2017 Nov;45:125-128. doi: 10.1016/j.jocn.2017.05.023. Epub 2017 Jun 7.
Intrasellar dermoid cysts are extremely unusual lesions, with only four cases reported to date, and have not been previously reported in association with sudden-onset symptoms. Here, we present the case of an intrasellar dermoid cyst with sudden-onset symptoms mimicking pituitary apoplexy in an elderly woman. A 69year-old woman presented with sudden onset of headache, dizziness, and decreased visual acuity. Magnetic resonance imaging of the sellar region showed an intrasellar lesion, which showed mixed hyper- and hypointense signal on T1-weighted and T2-weighted images and enhanced peripherally. Endocrine workup showed pituitary hormones within normal levels. According to these findings, the initial diagnosis of nonsecreting pituitary macroadenoma apoplexy was made. Intraoperatively, a large amount of whitish-yellow purulent material was found in the mass and the lesion was partially removed, owing to tight adhesion between remanent mass and surrounding neurovascular structures. Pathology showed a dermoid cyst with abundant neutrophil infiltrations.
鞍内皮样囊肿是极为罕见的病变，迄今为止仅报道过4例，且此前尚无与突发症状相关的报道。在此，我们报告一例老年女性鞍内皮样囊肿，其突发症状酷似垂体卒中。一名69岁女性突发头痛、头晕及视力下降。鞍区磁共振成像显示鞍内有一病变，在T1加权像和T2加权像上呈混杂高信号和低信号，并呈周边强化。内分泌检查显示垂体激素水平正常。根据这些发现，初步诊断为无分泌功能的垂体大腺瘤卒中。术中，在肿块内发现大量灰白色脓性物质，由于残留肿块与周围神经血管结构紧密粘连，病变仅部分切除。病理显示为伴有大量中性粒细胞浸润的皮样囊肿。
