[A case of intrasellar meningioma mimicking pituitary adenoma].
[A case of intrasellar meningioma mimicking pituitary adenoma].
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类似垂体腺瘤的鞍内脑膜瘤1例[J].
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
T. Ishihara
中科院分区：
文献类型：
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作者：
S. Matsumoto;M. Hayase;H. Imamura;Y. Oda;H. Kikuchi;M. Katayama;T. Ishihara
作者报告了一例罕见的鞍内脑膜瘤。一位60岁男性因全身疲劳评估而入院。他没有神经缺陷包括视觉功能。内分泌检查显示全垂体功能减退。颅平片显示蝶鞍轻微增大，鞍背变薄。CT和MR显示鞍内肿块均匀增强，鞍上有轻微延伸。经蝶窦入路切除部分肿物，因为肿物非常坚固且出血。组织学诊断为移行性脑膜瘤。患者术后2年无肿瘤进展。由于鞍内脑膜瘤与垂体腺瘤的治疗策略有显著差异，术前必须加以区分。尽管近年来神经诊断影像学有了很大的进步，但垂体腺瘤和鞍内脑膜瘤的鉴别仍然很困难。当我们重新评估MR成像时，我们认识到肿瘤已经表现出特定的表现，排除了垂体腺瘤，即动态MR研究中早期的明亮均匀强化，致密强化，以及肿块内的流动空洞信号。作者强调，仔细评估磁共振成像将有助于鞍内脑膜瘤模拟垂体大腺瘤患者的正确术前诊断。
The authors report a patient with a rare intrasellar meningioma mimicking pituitary adenoma. A 60-year-old man was admitted to our hospital for evaluation of general fatigue. He had no neurological deficit including visual function. Endocrinological tests revealed panhypopituitarism. The craniogram showed slight enlargement of the sella turcica with thinning of the dorsum sellae. CT scan and MR imaging demonstrated a homogeneously enhanced intrasellar mass with slight suprasellar extension. Partial removal of the mass was performed via the transsphenoidal approach because it was extremely firm and hemorrhagic. Histological diagnosis was transitional meningioma. The patient has been well for two years after surgery without tumor progression on MR imaging. It is mandatory to distinguish intrasellar meningioma from pituitary adenoma preoperatively because of marked difference in their treatment strategies. Despite recent advances in neurodiagnostic imaging, it may still be difficult to differentiate pituitary adenoma from intrasellar meningioma. When we re-evaluated the MR imaging, we recognized that the tumor had demonstrated specific findings, ruling out pituitary adenoma, namely bright and homogeneous enhancement, dense enhancement in the early phase on the dynamic MR study, and flow void signal within the mass. The authors emphasize that careful evaluations of MR imaging will allow the correct preoperative diagnosis in patients with intrasellar meningioma mimicking pituitary macroadenoma.