Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
World Neurosurg. 2020 Jul;139:310-313. doi: 10.1016/j.wneu.2020.04.096. Epub 2020 Apr 24.
Pituitary blastoma is a malignant neoplasm of the pituitary gland that was recognized by the World Health Organization in 2017. It is commonly diagnosed in children before 24 months of age. Here, we report the first case of a young adult patient who was diagnosed with pituitary blastoma with increased levels of growth hormone instead of adrenocorticotropic hormone and provide a review of the literature.
A 19-year-old woman presented to our hospital with visual disturbance. She had a medical history of Wilms' tumor and multinodular goiter. The brain imaging showed a 3.2 × 2.5 × 1.8-cm solid sellar and suprasellar cystic mass that upwardly displaced the optic chiasm. She had an elevated level of growth hormone but a normal level of adrenocorticotropic hormone, cortisol, and prolactin. The mass was subtotally removed through the left pterional craniotomy. The pathologic examination suggested a pituitary blastoma. Thereafter, the patient was treated with chemotherapy and radiotherapy. At 4-year follow-up postsurgery, her overall well-being is good.
Although in this case the patient was a young adult, pituitary blastoma should be taken into consideration when children have an enhanced sellar and suprasellar mass with peripherally located cysts.
垂体母细胞瘤是一种 2017 年被世界卫生组织认可的垂体恶性肿瘤。它通常在 24 个月龄之前的儿童中诊断出来。在这里,我们报告了首例青年患者的垂体母细胞瘤病例,其表现为生长激素水平升高而非促肾上腺皮质激素升高,并对文献进行了回顾。
一名 19 岁女性因视力障碍就诊于我院。她曾患有肾母细胞瘤和多结节性甲状腺肿。脑部影像学检查显示一个 3.2×2.5×1.8cm 的实性鞍内和鞍上囊性肿块,向上推挤视交叉。她的生长激素水平升高,但促肾上腺皮质激素、皮质醇和催乳素水平正常。该肿块通过左侧翼点开颅术部分切除。病理检查提示为垂体母细胞瘤。此后,患者接受了化疗和放疗。术后 4 年随访时,她的整体状况良好。
尽管本例患者为青年,但当儿童出现鞍内和鞍上肿块伴周围性囊肿时,应考虑垂体母细胞瘤。