Hiyama H, Kubo O, Yato S, Kagawa M, Kitamura K
No Shinkei Geka. 1986 Mar;14(3 Suppl):435-40.
A case of pituitary adenoma associated with Rathke's cleft cyst is reported. A 35-year-old woman suffering from visual disturbance, polydipsia-polyuria and amenorrhea galactorrhea was admitted. Since 3 years before admission, she had been administered thyradin under the diagnosis of primary hypothyroidism. Visual acuity was 0.1 on the right and 0.06 on the left, and visual field examination showed bitemporal hemianopsia. Endocrinological study disclosed primary hypothyroidism and moderate hypopituitarism. CT scan showed a low density mass with ring-like enhancement extending in the enlarged sellar cavity and in the suprasellar region. MRI showed a cystic mass in the sellar cavity extending to the suprasellar region, and a solid mass in the left posterior part of the sellar cavity, and the later was thought to be pituitary adenoma. On August 27, 1984, right frontal craniotomy was performed. The right optic nerve was compressed upward, and the right carotid artery laterally with a grayish bulging mass. About 3 ml of grayish colloidal fluid was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and visual field defects were improved. Endocrine examination revealed panhypopituitarism. Histologically, the cyst wall was composed of ciliated columnar cells and partially stratified squamous cells. The solid part showed typical pituitary adenoma. There are 5 reports in the literature on the combination of a pituitary adenoma and a Rathke's cleft cyst. In our case, it is thought that the long-standing hypothyroidism induced pituitary adenoma. Therefore, our case with combination of a pituitary adenoma and a Rathke's cleft cyst should be regarded as an occasional coexistence rather than the entity of the transitional cell tumor.
报告一例垂体腺瘤合并拉克氏裂囊肿。一名35岁女性因视力障碍、烦渴多尿及闭经溢乳入院。入院前3年，她因原发性甲状腺功能减退接受甲状腺素治疗。右眼视力0.1，左眼视力0.06，视野检查显示双颞侧偏盲。内分泌学检查发现原发性甲状腺功能减退和中度垂体功能减退。CT扫描显示鞍内扩大及鞍上区域有一低密度肿块，呈环形强化。MRI显示鞍内一囊肿性肿块延伸至鞍上区域，鞍内左侧后部有一实性肿块，后者被认为是垂体腺瘤。1984年8月27日，行右额开颅手术。右视神经被向上压迫，右颈动脉被向外侧压迫，有一灰白色隆起肿块。吸出约3ml灰白色胶样液体，切除囊肿包膜。术后病程顺利。视力和视野缺损得到改善。内分泌检查显示全垂体功能减退。组织学上，囊肿壁由纤毛柱状细胞和部分复层鳞状细胞组成。实性部分显示为典型的垂体腺瘤。文献中有5例关于垂体腺瘤与拉克氏裂囊肿合并的报道。在我们的病例中，认为长期的甲状腺功能减退诱发了垂体腺瘤。因此，我们这例垂体腺瘤与拉克氏裂囊肿合并的病例应被视为偶然并存，而非过渡性细胞瘤这一实体。
