Hashino Kohei, Sato Taku, Kishida Yugo, Kuromi Yosuke, Kiko Yuichiro, Yamada Masayuki, Tambara Masao, Sakuma Jun, Saito Kiyoshi
Department of Neurosurgery, Fukushima Medical University.
No Shinkei Geka. 2021 Jan;49(1):185-191. doi: 10.11477/mf.1436204374.
An ependymoma of the sella turcica and the suprasellar region has been described by only 10 reports in the available literature. We describe similar pathology in a 70-year-old woman who presented with dementia and visual disturbance. Magnetic resonance imaging with gadolinium revealed a mixed contrast-enhanced lesion(maximum diameter 3.5 cm)in the sella turcica and suprasellar area associated with a noncommunicating hydrocephalus. The patient was preoperatively presumptively diagnosed with a craniopharyngioma. The lesion was adherent to the hypothalamus, and the third ventricular floor was completely resected via an endoscopic endonasal transsphenoidal approach. Histopathological findings confirmed an ependymoma. Although her visual disturbance improved, the patient developed postoperative panhypopituitarism. She has had no recurrence for 7 years postoperatively. An ependymoma of the sella turcica and the suprasellar region is extremely rare; establishing the preoperative diagnosis is challenging in such patients. Maximum tumor resection and long-term follow-up are essential for good prognosis.
在现有文献中，仅10篇报道描述过蝶鞍及鞍上区域的室管膜瘤。我们描述了一名70岁女性的类似病例，该患者表现为痴呆和视力障碍。钆增强磁共振成像显示，蝶鞍和鞍上区域有一个混合强化病变（最大直径3.5 cm），伴有非交通性脑积水。患者术前初步诊断为颅咽管瘤。病变与下丘脑粘连，通过内镜鼻内经蝶窦入路完全切除了第三脑室底部。组织病理学检查结果证实为室管膜瘤。尽管患者的视力障碍有所改善，但术后出现了全垂体功能减退。术后7年她未复发。蝶鞍及鞍上区域的室管膜瘤极为罕见；对此类患者进行术前诊断具有挑战性。最大限度地切除肿瘤并进行长期随访对良好预后至关重要。
