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内镜经鼻蝶窦入路切除同时存在的垂体腺瘤和脑膜瘤:两例报告及文献复习。

Endoscopic endonasal resection of coexisting pituitary adenoma and meningioma: Two cases' report and literature review.

机构信息

Department of neurosurgery, the First Affiliated Hospital of Nanchang University, 17, Yong Wai Zheng Street, Nanchang, China.

Department of neurosurgery, the First Affiliated Hospital of Nanchang University, 17, Yong Wai Zheng Street, Nanchang, China.

出版信息

Neurochirurgie. 2021 Nov;67(6):611-617. doi: 10.1016/j.neuchi.2021.02.004. Epub 2021 Feb 27.

Abstract

INTRODUCTION

The coexistence of pituitary adenoma (PA) and para/suprasellar meningioma is an extremely rare event, which generally occurs in previous case reports. Literature on the endonasal endoscopic approach (EEA) to treat such synchronous tumours remains sparse.

CASE DESCRIPTION

Two cases of concomitant sellar and supra/parasellar tumours are reported. A 62-year-old woman with a PA and a tuberculum sellae meningioma and a 56-year-old woman with a PA and a cavernous sinus (CS) meningioma. Both coexisting tumours were resected through a single extended EEA and achieved a good prognosis. To the best of our knowledge, endoscopic endonasal resection of coexisting PA and CS meningioma has not been previously reported in the literature.

CONCLUSION

Our reports add to the literature two cases of coexisting PA and meningioma, with different consistence in sellar and para/suprasellar regions. Furthermore, the present case adds to the evidence that in the rare situation of coexisting sellar and suprasellar tumours located in the same sagittal plane, an extended EEA allows adequate exposure and safe removal of both tumours. However, for tumours coexisting in the sellar and parasellar region in the same coronal plane, we should draw attention to this rare situation for differential diagnosis of synchronous PA and CS meningioma to avoid unnecessary surgery and to decide the best strategy for treatment.

摘要

简介

垂体腺瘤(PA)和鞍旁/鞍上脑膜瘤并存是一种极为罕见的情况,通常见于以往的病例报告。关于经鼻内镜入路(EEA)治疗此类同步肿瘤的文献仍然很少。

病例描述

报告了两例同时存在鞍内和鞍旁/鞍上肿瘤的病例。一例 62 岁女性,患有 PA 和鞍结节脑膜瘤;另一例 56 岁女性,患有 PA 和海绵窦(CS)脑膜瘤。两种共存的肿瘤均通过单一的扩展 EEA 切除,取得了良好的预后。据我们所知,内镜经鼻蝶窦切除术治疗同时存在的 PA 和 CS 脑膜瘤在文献中尚未报道。

结论

我们的报告增加了两例同时存在 PA 和脑膜瘤的病例,在鞍内和鞍旁/鞍上区域的一致性不同。此外,本病例进一步证明,在罕见的情况下,位于同一矢状面的鞍内和鞍上肿瘤,扩展的 EEA 可以充分暴露并安全切除这两种肿瘤。然而,对于位于同一冠状面的鞍内和鞍旁区域的共存肿瘤,我们应该注意这种罕见情况,以便对同时存在的 PA 和 CS 脑膜瘤进行鉴别诊断,避免不必要的手术,并决定最佳的治疗策略。

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