Laun A, Lenzen J, Hildebrandt G, Schachenmayr W
Department of Neurosurgery, Justus Liebig University Giessen.
Zentralbl Neurochir. 1993;54(3):119-24.
The case of a 61 years old female patient with coincidental tuberculum sellae meningeoma and pituitary adenoma is demonstrated. Because of deteriorating vision of the left eye and bitemporal hemianopia the patient was investigated. Primary arranged computertomographical investigation showed a tall intra- and suprasellar solid homogeneous tumor. The plain skull film revealed sellar enlargement; angiographically craniolateral displacement of Aa. cerebri anteriores was found. Only MRI cleared up two coexisting tumors, an intrasellar lower enhancing tumor close to another extra-/parasellar. Neuroendocrinological investigations including insulinhypoglycaemiatest and the combined pituitary anterior lobe test showed findings to be seen typically in tuberculum sellae meningeomas. Only very discrete signs for a disturbance of anterior lobe secretion could be found. Postoperatively only a discrete deterioration of clinical symptoms and neuroendocrinological findings were noticed. The diagnosis of two coincidental tumors was confirmed histologically. Two years after operation no tumor-recurrence was seen. This case is comparable with cases published until now.
本文展示了一例61岁女性患者,其同时患有鞍结节脑膜瘤和垂体腺瘤。由于左眼视力恶化和双颞侧偏盲,对该患者进行了检查。最初安排的计算机断层扫描显示鞍内和鞍上有一个高大的实性均匀肿瘤。头颅平片显示蝶鞍扩大;血管造影显示大脑前动脉向颅外侧移位。只有磁共振成像(MRI)明确了两个并存的肿瘤,一个鞍内较低强化的肿瘤靠近另一个鞍外/鞍旁肿瘤。包括胰岛素低血糖试验和垂体前叶联合试验在内的神经内分泌检查显示出鞍结节脑膜瘤的典型表现。仅发现非常轻微的前叶分泌紊乱迹象。术后仅注意到临床症状和神经内分泌检查结果有轻微恶化。组织学证实了两个并存肿瘤的诊断。术后两年未见肿瘤复发。该病例与迄今已发表的病例相似。