Daita G, Makino K, Goto S, Ueno K, Takamura H
No Shinkei Geka. 1976 Jul;4(7):699-706.
It is not common to have experienced the nasopharyngeal extension of pituitary adenomas. Recently we have experienced such a case. A man, aged 18, height 168 cm, weight 66 kg, who admitted to the hospital with the complaints of headache, left nasal obstruction, loss of visual acuity and defect of his temporal fields. On examination of both fundi there was primary optic atrophy. At this time large tumor could be seen in the nasopharyngeal cavity. Plain X-ray showed that the pituitary fossa was definitely enlarged and that there was considerable destruction of the sella and the clivus. Definite soft tissue mass could be visualised clearly by tomography. Via transoral and transsphenoidal approach, total removal of the nasopharyngeal tumor and intracapsulary subtotal resection of the tumor were performed. Microscopical examination established the diagnosis of chromophobe adenoma. On postoperative examination of hypothalamopituitary function he had no responces to insulin hypoglycemia and arginine infusion in growth hormone. 60Co irradiation, totally 6,000 rad, was given. Two years postoperatively he showed fairly good deal of improvement of his visual field defect. There was no serious complaints other than visual impairment on the left eye.
垂体腺瘤向鼻咽部扩展并不常见。最近我们遇到了这样一个病例。一名18岁男性，身高168厘米，体重66公斤，因头痛、左侧鼻塞、视力减退和颞侧视野缺损入院。检查双眼眼底发现原发性视神经萎缩。此时可见鼻咽腔内有巨大肿瘤。X线平片显示垂体窝明显扩大，蝶鞍和斜坡有相当程度的破坏。断层扫描可清晰显示明确的软组织肿块。经口经蝶窦入路，完整切除鼻咽部肿瘤并对肿瘤进行囊内次全切除。显微镜检查确诊为嫌色性腺瘤。术后检查下丘脑 - 垂体功能，他对胰岛素低血糖和精氨酸输注刺激生长激素分泌无反应。给予60钴照射，总量6000拉德。术后两年，他的视野缺损有相当大的改善。除左眼视力障碍外，无其他严重不适。
