Guenot M, Bataille B, Wager M
Service de Neurochirurgie du Pr F. Lapierre, CHU de Poitiers.
Neurochirurgie. 1994;40(4):263-6.
This 67 year-old man experienced the sudden onset of generalized headache followed by visual troubles. Examination showed a poor visual acuity of the right eye with a palsy of the right third nerve and signs of panhypopituitarism confirmed by endocrinologic testing. CT- scan and MRI showed a large sellar tumor with a necrotic portion in the middle, so that the pre-operative diagnosis was: pituitary adenoma. The tumor was removed through a trans-sphenoïdal approach. The pathologic diagnosis was benign schwannoma. A review of the literature showed that this was the second reported case of an intra sellar schwannoma mimicking a pituitary adenoma clinically as well as radiologically. Surgical removal of these lesions by a trans-sphenoïdal approach seems to be more difficult than for an adenoma. The histopathogenic origin of such tumors could be either ectopic schwann cells of peri-vascular schwann cells in the sellar region.
这位67岁男性突发全身性头痛，随后出现视力问题。检查发现右眼视力差，右侧动眼神经麻痹，内分泌检查证实有全垂体功能减退的体征。CT扫描和MRI显示鞍区有一个大肿瘤，中间有坏死部分，因此术前诊断为：垂体腺瘤。通过经蝶窦入路切除肿瘤。病理诊断为良性神经鞘瘤。文献回顾显示，这是第二例临床上和放射学上都酷似垂体腺瘤的鞍内神经鞘瘤病例报告。经蝶窦入路手术切除这些病变似乎比切除腺瘤更困难。此类肿瘤的组织病理学起源可能是鞍区血管周围神经鞘细胞的异位神经鞘细胞。
