鞍上区域组织细胞肉瘤：病例说明

Histiocytic sarcoma of the suprasellar region: illustrative case.

作者信息

Natori Ikuya, Tanioka Daisuke, Kobayashi Yusuke, Shimizu Katsuyoshi, Mizutani Tohru, Omatsu Mutsuko, Nemoto Tetsuo

机构信息

Department of Neurosurgery, Showa University School of Medicine, Shinagawa, Tokyo, Japan.

Department of Clinical Pathology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.

出版信息

J Neurosurg Case Lessons. 2025 Mar 24;9(12). doi: 10.3171/CASE24297.

DOI:10.3171/CASE24297

PMID:40127477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11933653/

Abstract

BACKGROUND

Histiocytic sarcoma (HS) is a rare malignant tumor of histiocytic origin, both morphologically and immunohistologically. Herein, the authors report the case of a suprasellar tumor confirmed as HS after craniotomy, which presented a diagnostic challenge.

OBSERVATIONS

A 58-year-old man presented with panhypopituitarism. To protect the patient's visual function and obtain a diagnosis, craniotomy was performed for tumor removal. Based on the immunohistological staining results, the tumor tested positive for both CD68 and CD163 and negative for CD1a, CD21, and MP0. Hence, the patient was diagnosed with HS. The tumor grew rapidly after surgery. Thus, the patient underwent reoperation. The patient's visual acuity and visual field deficits improved. However, he developed intractable electrolyte abnormalities caused by hypothalamic damage. Then, he exhibited intractable seizures and pneumonia and died 4 months after surgery.

LESSONS

This report emphasizes the rarity of suprasellar HS and its associated challenges in diagnosis and surgical treatment. https://thejns.org/doi/10.3171/CASE24297.

摘要

背景

组织细胞肉瘤（HS）是一种罕见的组织细胞起源的恶性肿瘤，在形态学和免疫组织学上均如此。在此，作者报告一例经开颅手术后确诊为HS的鞍上肿瘤病例，该病例带来了诊断挑战。

观察结果

一名58岁男性出现全垂体功能减退。为保护患者的视觉功能并明确诊断，进行了开颅手术以切除肿瘤。根据免疫组织化学染色结果，肿瘤CD68和CD163均呈阳性，而CD1a、CD21和MPO呈阴性。因此，该患者被诊断为HS。术后肿瘤生长迅速。于是，患者接受了再次手术。患者的视力和视野缺损有所改善。然而，他因下丘脑损伤出现了难以治疗的电解质紊乱。随后，他出现了难治性癫痫和肺炎，并在术后4个月死亡。