Tsuiki K, Abe S, Chiba M, Murakami H, Saiki I, Kanaya H
No Shinkei Geka. 1987 Mar;15(3):301-5.
A 43-year-old female was admitted showing abnormal feeling in the left eye region. Left facial hypesthesia and quadrantic hemianopsia of left eye were the detectable neurological findings. A plain skull x-ray film revealed a double floor and dilatation of the sella turcica. The tomogram of the sella turcica demonstrated a dilatation of superior orbital fissure. Caudocranial projection revealed a dilatation of foramen ovale. A computerized tomography scan revealed a slightly high density tumor which was enhanced slightly with a contrast medium in the parasellar region and left middle fossa. Carotid angiogram demonstrated the displacement of the left carotid fork to the upper and lateral direction. However, no other sign was found. The sinogram of cavernous sinus clearly demonstrated an indentation in the left cavernous sinus. The endocrinological tests were almost normal except for hyperprolactinemia. A trigeminal neurinoma and a pituitary tumor were suspected. The tumor was totally removed and was histologically diagnosed as a cavernous angioma. At operation it seems to be extracerebral in the middle fossa and originate in the cavernous sinus. Diagnostic problems endocrine findings and the origin are discussed.
一名43岁女性因左眼区域感觉异常入院。可检测到的神经系统体征为左侧面部感觉减退和左眼象限性偏盲。颅骨平片显示蝶鞍双底及扩大。蝶鞍体层摄影显示眶上裂扩大。尾颅位投照显示卵圆孔扩大。计算机断层扫描显示鞍旁区域和左中颅窝有一略高密度肿瘤，增强扫描后有轻度强化。颈动脉血管造影显示左颈动脉分叉向上外侧移位。然而，未发现其他体征。海绵窦造影清晰显示左侧海绵窦有压迹。除高催乳素血症外，内分泌检查基本正常。怀疑为三叉神经鞘瘤和垂体瘤。肿瘤被完全切除，组织学诊断为海绵状血管瘤。手术中该肿瘤似乎位于中颅窝脑外，起源于海绵窦。文中讨论了诊断问题、内分泌检查结果及肿瘤起源。
