伴有颅内动脉瘤的异位蝶鞍内生长激素释放垂体腺瘤

Asian journal of neurosurgery Pub Date : 2024-06-27 eCollection Date: 2024-09-01 DOI:10.1055/s-0042-1757434
Hernando Cifuentes-Lobelo, Marcelo A Castañeda-Duarte, Diego Ruiz-Diaz, William Cortes-Lozano
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引用次数: 0

摘要

垂体腺瘤是一种最常见的颅内肿瘤。这些肿瘤可延伸至蝶鞍外,但极少异位起源于蝶鞍区。一名 71 岁的患者来我院就诊,既往有未控制的动脉高血压临床病史,并伴有新发的高强度搏动性头痛。由于怀疑是高血压急症并可能危及脑部,医生为其进行了头部非增强计算机断层扫描。发现蝶窦内有肿块。内分泌检查显示生长激素显著升高。偶然发现了脑动脉瘤,在肿块治疗前进行了血管内治疗。随后,患者成功地通过鼻内镜经蝶窦途径进行了全切除术。组织病理学结果与垂体异位腺瘤一致。术后记录显示,患者体内的体液调节素 C 水平有所改善。
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Ectopic Intrasphenoidal Growth Hormone Releasing Pituitary Adenoma Associated with an Intracranial Aneurysm.

Pituitary adenomas are a type of of the most frequent intracranial tumors. These tumors can extend outside the sella, but very rarely originate ectopically to the sellar region. A 71-year-old patient presented to our institution, with prior clinical history of noncontrolled arterial hypertension and new-onset high-intensity pulsatile headache. Upon suspicion of a hypertensive emergency with probable brain compromise, a nonenhanced computed tomography of the head was performed. A mass within the sphenoid sinus was found. Endocrinological workup demonstrated a significant elevation of the growth hormone. As an incidental finding, a brain aneurysm was evidenced, which was treated endovascularly prior to the mass treatment. Subsequently, the patient successfully underwent a gross total resection through an endonasal transsphenoidal approach. Histopathological results were consistent with a pituitary ectopic adenoma. A postoperative improvement in levels of somatomedin C was documented postoperatively.

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