Attiku Yamini, Rishi Pukhraj, Bassi Shikha
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.
Department of Neuro-Ophthalmology Services, Sankara Nethralaya, Chennai, India.
Ocul Oncol Pathol. 2019 Aug;5(5):319-322. doi: 10.1159/000496149. Epub 2019 Jan 24.
To report a rare case of optic disc melanocytoma coexistent with pituitary adenoma.
Ophthalmological examination with perimetry and magnetic resonance imaging (MRI) of the brain and orbits was done.
A 42-year-old woman presented with complaints of progressive diminution of vision in the right eye of 6 weeks' duration. Visual acuity in the affected right eye was 6/60 and in the left eye it was 6/6. On examination, a brown-black lesion was noted over the optic nerve head in the right eye. On perimetry, the visual field was constricted in the right eye and a superior altitudinal defect was found in the left eye. MRI of the brain and orbits revealed a pituitary adenoma with suprasellar extension. The patient underwent endoscopic transphenoidal pituitary adenoma excision with uneventful recovery. Three months following surgery, visual acuity improved to 6/6 in both eyes with partial visual field recovery and was maintained at 10 months of follow-up. There was no recurrence or metastasis.
A high degree of suspicion is required to screen for possible coexistent orbital or central nervous system pathology in cases of optic disc melanocytoma with disproportionate signs or symptoms.
报告一例罕见的视盘黑色素细胞瘤合并垂体腺瘤病例。
进行了眼科视野检查以及脑部和眼眶的磁共振成像(MRI)检查。
一名42岁女性,主诉右眼视力进行性下降6周。患侧右眼视力为6/60,左眼视力为6/6。检查发现右眼视神经乳头有棕黑色病变。视野检查显示右眼视野缩小,左眼有上半侧视野缺损。脑部和眼眶的MRI显示垂体腺瘤并向鞍上延伸。患者接受了内镜经蝶窦垂体腺瘤切除术,恢复顺利。术后三个月,双眼视力提高到6/6,视野部分恢复,并在随访10个月时保持稳定。无复发或转移。
对视盘黑色素细胞瘤出现不相称体征或症状的病例,需要高度怀疑是否存在可能并存的眼眶或中枢神经系统病变。