Tonari Masahiro, Matsuo Junko, Oku Hidehiro, Sugasawa Jun, Ikeda Tsunehiko, Tatsuzawa Kazunori, Fujita Tomoaki
Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.
Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Case Rep Ophthalmol. 2017 May 29;8(2):301-307. doi: 10.1159/000477199. eCollection 2017 May-Aug.
The purpose of this study was to report the case of a female patient who had a giant cell tumor in the paranasal sinus during childhood, and while undergoing multiple resection surgeries experienced optic atrophy in both eyes.
This study involved a 35-year-old woman who was previously diagnosed with a giant cell tumor of the paranasal sinus bone at age 13. A CT scan revealed a large tumor extending from the sphenoid sinus to the ethmoid sinus. At age 14, a tumor resection was performed in conjunction with radiation therapy. However, after resection and radiation therapy there were repeated recurrences, and additional resections were performed. Ophthalmically, there was marked optical atrophy in both eyes, and Goldmann visual field perimetry revealed that only the arcuate peripheral area remained on the nasal side of the right eye, and that there were dark spots in the paracentral area of the left eye.
In this case, a large giant cell tumor occurred in the sphenoid sinus and ethmoid sinus during childhood, and it is thought that optic atrophy was caused by compressive optic neuropathy. The sphenoid sinus and ethmoid sinuses are anatomically close to the optic nerve, and when a tumor grows larger at this site it can easily put pressure on the optic nerve. Therefore, early detection and treatment are important.
本研究旨在报告一名女性患者的病例，该患者童年时患鼻窦巨细胞瘤，在接受多次切除手术过程中出现双眼视神经萎缩。
本研究涉及一名35岁女性，她在13岁时被诊断为鼻窦骨巨细胞瘤。CT扫描显示一个大肿瘤从蝶窦延伸至筛窦。14岁时，进行了肿瘤切除并结合放射治疗。然而，切除和放射治疗后肿瘤反复复发，并进行了额外的切除手术。眼科检查发现双眼明显视神经萎缩，Goldmann视野检查显示右眼鼻侧仅保留弓形周边区域，左眼中心旁区域有暗点。
在该病例中，童年时蝶窦和筛窦出现巨大巨细胞瘤，认为视神经萎缩是由压迫性视神经病变所致。蝶窦和筛窦在解剖学上靠近视神经，当该部位肿瘤增大时很容易对视神经施加压力。因此，早期发现和治疗很重要。
