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[一例间变性星形细胞瘤合并垂体腺瘤]

[A case of anaplastic astrocytoma associated with pituitary adenoma].

作者信息

Ezura M, Kayama T, Sakurai Y, Ogawa A, Wada T

机构信息

Department of Neurosurgery, Sendai National Hospital.

出版信息

No Shinkei Geka. 1988 Dec;16(13):1505-9.

PMID:3226501
Abstract

A case of anaplastic astrocytoma associated with pituitary adenoma is reported. The patient was a 33-year-old male, who was admitted with complaints of sensory aphasia, slight left motor paresis, and visual field defects. Neurological examination disclosed sensory and motor aphasia, Gerstmann's syndrome, slight left motor paresis, right homonymous hemianopsia, and bilateral choked discs. Computed tomography revealed a low density mass lesion with slight enhancement in the left temporal region and a ring-like enhanced mass lesion in the suprasellar region. In MRI, both the left temporal and the suprasellar lesions are depicted as low signal intensity areas in T1 weighted imaging, but as high signal intensity areas in T2 weighted imaging. Craniotomy was performed and both tumors were almost totally removed. The tumor in the left temporal region was diagnosed as anaplastic astrocytoma and the other in the suprasellar region was diagnosed as chromophobe adenoma. Multiple primary intracranial tumors of different cell types are rare. About a hundred cases can be found in medical literature. More than two thirds of them are cases of glioma associated with meningioma, but other combinations of tumors are extremely rare. We now report this case of astrocytoma associated with pituitary adenoma. In the literature, there are only 5 cases of similar combination. It is believed that astrocytoma and pituitary adenoma are histologically different. In three of five reported cases, the tumors were in close proximity to each other, but it is doubtful that their close proximity was related to the fact that they developed concurrently.

摘要

报告了一例间变性星形细胞瘤合并垂体腺瘤的病例。患者为33岁男性,因感觉性失语、轻度左侧运动性轻瘫和视野缺损入院。神经系统检查发现感觉性和运动性失语、格斯特曼综合征、轻度左侧运动性轻瘫、右侧同向性偏盲和双侧视乳头水肿。计算机断层扫描显示左侧颞叶区域有一个低密度肿块病变,有轻微强化,鞍上区域有一个环状强化肿块病变。在磁共振成像中,左侧颞叶和鞍上病变在T1加权成像中均表现为低信号强度区域,但在T2加权成像中表现为高信号强度区域。进行了开颅手术,两个肿瘤几乎完全切除。左侧颞叶区域的肿瘤被诊断为间变性星形细胞瘤,鞍上区域的另一个肿瘤被诊断为嫌色性腺瘤。不同细胞类型的多发性原发性颅内肿瘤很少见。医学文献中可找到约100例。其中超过三分之二是胶质瘤合并脑膜瘤的病例,但其他肿瘤组合极为罕见。我们现在报告这例星形细胞瘤合并垂体腺瘤的病例。文献中仅有5例类似组合的病例。据信星形细胞瘤和垂体腺瘤在组织学上是不同的。在报告的5例病例中,有3例肿瘤彼此相邻,但它们相邻是否与它们同时发生有关尚值得怀疑。

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