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经鼻内镜经蝶窦手术治疗罕见鞍区病变：8例报告并文献复习

Endoscopic endonasal transsphenoidal surgery for unusual sellar lesions: eight cases and review of the literature.

作者信息

Wu Jiandong, Deng Peng, Qian Jinhong, Lu Yanli, Ding Zhiliang, Hu Xiaolong, Gong Yuhui, Tang Xiaoyu, Ma Mian

机构信息

Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.

Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.

出版信息

Front Neurol. 2024 Feb 13;15:1309691. doi: 10.3389/fneur.2024.1309691. eCollection 2024.

DOI:10.3389/fneur.2024.1309691
PMID:38414554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10896968/
Abstract

BACKGROUND

Preoperative imaging for some unusual lesions in the sellar region can pose challenges in establishing a definitive diagnosis, impacting treatment strategies.

METHODS

This study is a retrospective analysis of eight cases involving unusual sellar region lesions, all treated with endoscopic endonasal transsphenoidal surgery (EETS). We present the clinical, endocrine, and radiological characteristics, along with the outcomes of these cases.

RESULTS

Among the eight cases, the lesions were identified as follows: Solitary fibrous tumor (SFT) in one case, Lymphocytic hypophysitis (LYH) in one case, Cavernous sinus hemangiomas (CSH) in one case, Ossifying fibroma (OF) in two cases; Sphenoid sinus mucocele (SSM) in one case, Pituitary abscess (PA) in two cases. All patients underwent successful EETS, and their diagnoses were confirmed through pathological examination. Postoperatively, all patients had uneventful recoveries without occurrences of diabetes insipidus or visual impairment.

CONCLUSION

Our study retrospectively analyzed eight unusual lesions of the sellar region. Some lesions exhibit specific imaging characteristics and clinical details that can aid in preoperative diagnosis and inform treatment strategies for these unusual sellar diseases.

摘要

背景

蝶鞍区一些不常见病变的术前影像学检查在明确诊断方面可能具有挑战性，从而影响治疗策略。

方法

本研究对8例涉及蝶鞍区不常见病变的病例进行回顾性分析，所有病例均接受了鼻内镜下经蝶窦手术（EETS）。我们展示了这些病例的临床、内分泌和影像学特征以及治疗结果。

结果

在这8例病例中，病变诊断如下：孤立性纤维瘤（SFT）1例，淋巴细胞性垂体炎（LYH）1例，海绵窦血管瘤（CSH）1例，骨化性纤维瘤（OF）2例，蝶窦黏液囊肿（SSM）1例，垂体脓肿（PA）2例。所有患者均成功接受了EETS手术，其诊断通过病理检查得以证实。术后，所有患者恢复顺利，未发生尿崩症或视力损害。

结论

我们的研究回顾性分析了8例蝶鞍区不常见病变。一些病变表现出特定的影像学特征和临床细节，有助于术前诊断并为这些不常见的蝶鞍疾病制定治疗策略提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/688194aa23c0/fneur-15-1309691-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/0b7a3be5b3df/fneur-15-1309691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/79d2299747eb/fneur-15-1309691-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/86ebdbcef2dd/fneur-15-1309691-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/e4815966d210/fneur-15-1309691-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/b3c39468196c/fneur-15-1309691-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/fd49bf91dac7/fneur-15-1309691-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/fe3e06e25edd/fneur-15-1309691-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/688194aa23c0/fneur-15-1309691-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/0b7a3be5b3df/fneur-15-1309691-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/79d2299747eb/fneur-15-1309691-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/86ebdbcef2dd/fneur-15-1309691-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/e4815966d210/fneur-15-1309691-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/b3c39468196c/fneur-15-1309691-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/fd49bf91dac7/fneur-15-1309691-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/fe3e06e25edd/fneur-15-1309691-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07af/10896968/688194aa23c0/fneur-15-1309691-g008.jpg

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本文引用的文献

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Int J Surg Case Rep. 2024 Feb;115:109218. doi: 10.1016/j.ijscr.2023.109218. Epub 2024 Jan 2.
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Solitary fibrous tumor in the saddle area treated with neuroendoscopic surgery and proton therapy: A case report and literature review.经神经内镜手术和质子治疗的鞍区孤立性纤维瘤：病例报告及文献复习
Oncol Lett. 2023 Oct 10;26(6):505. doi: 10.3892/ol.2023.14092. eCollection 2023 Dec.
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A rare case of intracranial solitary fibrous tumor that is still alive after multiple surgical resections: a case report and review of the literature.
1例经多次手术切除后仍存活的颅内孤立性纤维瘤罕见病例：病例报告及文献复习
Front Neurol. 2023 Jul 10;14:1201964. doi: 10.3389/fneur.2023.1201964. eCollection 2023.
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Prognostic factors in transnasal endoscopic surgery for paediatric patients with ossifying fibroma of the paranasal sinuses and skull base.经鼻内镜手术治疗儿童鼻窦和颅底骨化纤维瘤的预后因素。
J Otolaryngol Head Neck Surg. 2023 Jul 26;52(1):48. doi: 10.1186/s40463-023-00641-w.
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Cavernous sinus hemangioma: Histopathological spectrum of 8 cases.海绵窦血管瘤：8例组织病理学谱
J Neuropathol Exp Neurol. 2023 Sep 20;82(10):884-886. doi: 10.1093/jnen/nlad058.
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The "chameleon" sellar lesions: a case report of unexpected sellar lesions.“变色龙”鞍区病变：一例意外鞍区病变的病例报告
Front Neurol. 2023 Apr 24;14:1149858. doi: 10.3389/fneur.2023.1149858. eCollection 2023.
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