Akimoto J, Nagura M, Onodera Y
Department of Neurosurgery, Mito Red Cross Hospital, Japan.
No To Shinkei. 1995 Nov;47(11):1092-7.
A 68-year-old man was admitted with suprasellar cystic tumor with obstructive hydrocephalus, and complaining of slowly progressive memory disturbance, gait disturbance and urinary incontinence. Neurological examination revealed bilateral visual disturbance and disorientation. Skull X-ray films revealed no dilatation of sella turnica and mild erosion of the dorsum sellae. A cystic suprasellar tumor was revealed extending upward to the third ventricular floor and the solid part of the tumor was homogeneously enhanced with Gd-DTPA on MRI. The T1-weighted sagittal MR image revealed a normal pituitary gland and the diaphragma sellae below the tumor. The tumor was totally removed via a bifrontal basal interhemispheric approach, and the tumor was attached to the pituitary stalk and was not contiguous with the pituitary gland. The histological diagnosis was sinusoidal type of chromophobe and non-functioning adenoma. Postoperative MRI revealed a preserved normal pituitary gland and the stalk. To our knowledge, only 11 cases of suprasellar ectopic pituitary adenoma have been reported. We reviewed their neuroradiological features and discussed the pathogenesis. In particular, cystic and nonfunctioning suprasellar ectopic pituitary adenoma may be difficult to distinguish from craniopharyngioma.
一名68岁男性因鞍上囊性肿瘤伴梗阻性脑积水入院，主诉有缓慢进展的记忆障碍、步态障碍和尿失禁。神经系统检查发现双侧视力障碍和定向障碍。头颅X线片显示蝶鞍无扩大，蝶鞍背轻度侵蚀。MRI显示鞍上有一囊性肿瘤向上延伸至第三脑室底部，肿瘤实性部分在注射钆喷酸葡胺后呈均匀强化。矢状位T1加权MR图像显示肿瘤下方垂体和鞍隔正常。肿瘤通过双额基底半球间入路完全切除，肿瘤附着于垂体柄，与垂体不相连。组织学诊断为窦性无嗜色性非功能性腺瘤。术后MRI显示垂体和垂体柄正常。据我们所知，仅报道过11例鞍上异位垂体腺瘤。我们回顾了其神经放射学特征并讨论了发病机制。特别是，鞍上囊性和无功能性异位垂体腺瘤可能难以与颅咽管瘤区分。
