Aini Rahimah, Sachlin Ida Sadja'ah, Chee Lai Chuang, Abdullah Baharudin
Department of Otorhinolaryngology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Kedah, Malaysia.
Allergy Rhinol (Providence). 2019 Dec 17;10:2152656719896580. doi: 10.1177/2152656719896580. eCollection 2019 Jan-Dec.
Giant pituitary adenomas are clinically nonfunctioning adenomas, and the clinical presentation is usually secondary to compression of the neighboring structures. Visual impairment and visual field defect are the most common preoperative symptoms, followed by headache. Generalized seizures may occur in giant pituitary adenomas when there is involvement of frontal lobes or medial temporal lobes. We present a case of a unilateral nasal mass with generalized seizures in a 55-year-old woman without prior episode of seizure and any predisposing factors. Imaging showed a sinonasal tumor with intracranial extension and histopathological examination confirmed a corticotroph adenoma. On seeing a patient with a unilateral nasal mass extending down from the roof of nasal cavity, olfactory neuroblastoma, or meningo-encephalocoele readily comes to mind. To avoid misdiagnosis and delay in treatment, imaging and, if possible, a biopsy should be considered. Giant pituitary adenoma although not common should be thought of as one of the differential diagnosis.
巨大垂体腺瘤是临床上的无功能腺瘤，临床表现通常继发于邻近结构受压。视力障碍和视野缺损是最常见的术前症状，其次是头痛。当额叶或颞叶内侧受累时，巨大垂体腺瘤可能会发生全身性癫痫发作。我们报告一例55岁女性病例，该患者有单侧鼻腔肿物并伴有全身性癫痫发作，既往无癫痫发作史及任何诱发因素。影像学检查显示鼻窦肿瘤伴有颅内扩展，组织病理学检查确诊为促肾上腺皮质激素腺瘤。当看到一名患者有从鼻腔顶部向下延伸的单侧鼻腔肿物时，很容易想到嗅神经母细胞瘤或脑膜脑膨出。为避免误诊和延误治疗，应考虑进行影像学检查，如有可能，还应进行活检。巨大垂体腺瘤虽然不常见，但应被视为鉴别诊断之一。
