鞍结节脑膜瘤合并垂体腺瘤1例

1病历摘要 男，54岁，因双眼视力下降、视物模糊伴头痛2个月余就诊。头颅MRI示鞍区占位（图1）。体格检查：左眼视野向心性缩小．颞上方视野大部缺损。右眼视野仅存鼻上方视岛；双侧视乳头水肿，右侧视乳头轻度萎缩．内分泌检查正常。拟诊巨大垂体瘤。因鞍上占位较大．行经额手术．术中发现前颅底鞍结节处脑膜瘤．     

垂体腺瘤与脑膜瘤并存五例报告

颅内多发多源性肿瘤临床少见,它可以表现在不同部位、不同源性同时存在。笔者曾遇5例垂体腺瘤与脑膜瘤并存,现报告如下。例1男性,45岁。因反复头痛、头晕3年而入院。神经系统检查未发现明显局灶性神经损害征,MRI扫描见鞍内微腺瘤及小脑幕脑膜瘤(4cm×4cm×5cm)并附着天幕。考虑患者无视力视野及内分泌障碍,先行脑膜瘤切除术,鞍内微腺瘤用伽玛刀治疗。随访4年,微腺瘤基本消失,患者至今正常工作。     

颅内垂体腺瘤合并脑膜瘤一例

患者女性，56岁。因反复头痛4年，视物模糊10个月，右眼视力下降5个月入院。查体：左眼视力正常，右眼视力40cm指数，视野双颞侧偏盲。X片示蝶鞍轻度扩大。CT：鞍区扩大，垂体窝有一肿块影，内呈囊性，右额叶大脑侧面有一圆形高密度影。MRI：蝶鞍扩大下凹，鞍区见一囊状实性信号肿块影，他相有液平面，FLAIR示高信号。增强可见囊壁及其分隔显著环状强化，     

显微手术切除垂体腺瘤40例体会

目的介绍显微手术切除垂体腺瘤的操作技术及经验。方法40例病人均采用显微手术切除肿瘤。结果40例垂体腺瘤中,镜下全切30例,次全切10例。术后随访3月￣2年3个月,恢复正常生活35例,轻残4例,重残1例。结论采用显微技术切除垂体腺瘤是目前治疗垂体腺瘤行之有效的方法。     

经蝶窦切除垂体腺瘤110例报告

本文报告经蝶窦显微外科手术切除垂体腺瘤１１０例，主要采用鼻小柱Ｕ形切口。文章对手术适应症、切口的选择、手术方法及常见并发症等加以讨论。     

典型难治性垂体腺瘤1例报告

正大部分垂体腺瘤(pituitary adenoma,PA)表现为良性肿瘤的病程,但是临床上仍然会遇到一些处理棘手、最终无法挽救患者生命的病例。本文报道1例垂体腺瘤,术前肿瘤较小,规则生长,Knosp分级1-2级,符合非侵袭垂体腺瘤(non-invasive PA,NIPA),术后病理分型也未达到"非典型垂体腺瘤(atypical PA,APA)"诊断标准。但是,第一次手术全切后,肿瘤短时间内(小于半年)复发,且复发后生     

垂体腺瘤合并脑血管病3例报告

我院收治3例垂体腺瘤合并脑血管病,现报告如下: 例1,男,45岁,因"视力下降、性欲减退2年,头痛2个月"入院.体检:神志清,胡须、阴毛稀少.视力:左0.8,右眼前手动.左眼颞侧、右眼周边视野缺损.双乳房可挤出稀白乳汁.血皮质醇:上午8时为422.29 nmol/l,下午4时为313.68 nmol/l;血泌乳素(prolactin, PRL)>9.1 nmol/l;雌二醇(estradiol,E)<70pmol/l,睾酮(testosterone, T)为5.86 nmol/l,其余正常.颅脑CT、MRI示3.7 cm×2.8 cm大小囊、实性肿块,位于鞍内及鞍上区,视交叉明显受压.行右翼点入路肿瘤切除术.术中见右侧颈内动脉床突上段有大小为3 mm的动脉瘤,给予夹闭.肿瘤位于视交叉前下方,有囊性变,质软易吸除.病理报告:垂体腺瘤.诊断:垂体腺瘤并动脉瘤.恢复顺利出院.随访5年无复发.     

巨大垂体腺瘤1例报道

1病例分析患者,男,45岁,因头昏伴视力减退3a加重1月入院。检查：神清语利,视力视野检查左眼10cm指动,右眼视力0.4,双眼颞侧偏盲。眉弓及颧骨突出,唇厚,鼻大,舌大;手足肢端肥大,双侧病理征未引出。术前CT片见鞍区占位,大小7.8cm×4.3cm×6.0cm,病变可见斑点样钙化,     

垂体脓肿误诊为垂体腺瘤1例

<正>垂体脓肿比较罕见,影像学检查很难与垂体腺瘤以及拉克氏囊肿相鉴别。我科最近收治1例垂体脓肿误诊为垂体腺瘤患者,现报道如下。1病例资料患者,男性,51岁,无明显诱因出现头晕、乏力伴轻微视物模糊1周入院,无发热。入院体格检查:神志清楚,双侧瞳孔等大等圆,直径3 mm,对光反射灵敏,眼球运动正常。左眼视力0.3,右眼视力0.4,双眼视野正常。垂体性激素检查正常,血常规正常。头颅MRI检查见鞍区囊性占位性病变(图     

巨大垂体腺瘤1例报道

1病例分析患者,男,45岁,因头昏伴视力减退3a加重1月入院。检查:神清语利,视力视野检查左眼10cm指动,右眼视力0.4,双眼颞侧偏盲。眉弓及颧骨突出,唇厚,鼻大,舌大;手足肢端肥大,双侧病理征未引出。术前CT片见鞍区占位,大小7.8cm×4.3cm×6.0cm,病变可见斑点样钙化,未见     

横纹肌样脑膜瘤1例报告

患者男性,37岁,因脑出血术后、持续昏迷10个月入院。患者因高血压脑出血于当地医院行“左颞骨窗开颅血肿清除术”,术后患者一直处于植物生存状态。促醒治疗期间发现左颞减压窗逐渐膨起、张力大,腰椎穿刺测脑脊液压力高达220mmH2O,考虑脑积水遂行脑室-腹腔分流术,术后意识无好转     

TSH pituitary adenoma: case report

We describe a rare case of thyroid-stimulating hormone-secreting pituitary adenoma in a patient with a clinical picture of hyperthyroidism, that developed bitemporal hemianopsia after four years of a known thyroid dysfunction. CT scan showed a pituitary tumor considered grade 2 and stage C according to Hardy-Vezina and Wilson. Treatment was surgical, initially by a transsphenoidal approach, in which only a biopsy was possible. The patient was then submitted to an orbital-pterional craniotomy with sub-total resection of the tumor. Complementary treatment was indicated with radiotherapy.     

横纹肌样脑膜瘤一例报告

患者,男,34岁,因突然不省人事伴呕吐于2004年9月1日入院,临床诊断：自发性左颞顶叶血肿(高血压性),伴脑疝。行小骨窗开颅清除血肿,血肿量约70mL。术后病情稳定。恢复期治疗期间,于2005年3月手术颅骨窗稍膨降,CT检查为幕上脑积水,未发现颅内肿瘤,行侧脑室腹腔分流术,手术后情     

Intraventricular malignant meningioma: one case report.

We report a case of primary intraventricular malignant meningioma in a 74-year-old man who presented with progressive weakness of the left limbs and dizziness, The preoperative magnetic resonance (MR) imaging of the head initially suggested that a glioblastoma multiforme or a metastatic lesion might be present. But later, the excised tumor was histologically diagnosed as a primary malignant meningioma. So far, only a few cases of intraventricular malignant meningioma have been reported. The MR imaging of this tumor has rarely been described in the literature. In the present case, the mass lesion showed hyperintensity on the T1-weighted image (T1WI) and hypointensity on the T2-weighted image (T2WI) which was not commonly seen in meningioma. The unusual MR imaging of this case may be attributed to the intratumoral hemorrhage. Although intraventricular malignant meningioma is difficult to diagnose based on MR or computed tomographic images alone, the characteristics of the MR images in the present case may offer an option for preoperative differential diagnosis of intraventricular tumors.     

A rare case of pituitary adenoma with calcification: a case report

Though craniopharyngioma remains the most common sellar suprasellar tumor with calcification, it can be seen very rarely in pituitary adenomas and Rathke's cleft cysts. Appreciation of the pattern of calcification in a sellar suprasellar lesion can give a clue to the nature of the lesion. The authors describe a 53-yearold male with a cystic sellar suprasellar lesion and curvilinear calcification that was managed by successful transsphenoidal surgery. The present case highlights the occurrence of calcification in a pituitary adenoma and the importance of recognizing the calcification pattern for pre-operative diagnosis of sellar suprasellar lesions that can help plan the surgical strategy and management.     

囊性脑膜瘤伴出血与钙化一例报告

患者,男,42岁,以“间断性头痛、头晕5年,加重伴抽搐1d”之主诉入院。病史中曾抽搐一次,为大发作,伴意识丧失,起于左腿,继而蔓延至全身。神经系统查体无阳性体征。头颅CT示:右顶枕部低密度及混杂密度影伴钙化(图1)。MR示:右顶枕叶6cm×3.5cm异常信号影,内部信号不均匀,可见不规则长T1长T2囊变区,实质部分以等信号为主,其内可见散在点状低信号钙化灶,周围片状水肿(图2,3)。初步诊断为:胶质瘤。旁砂粒体型囊性脑膜瘤,伴出血、钙化。最后诊断为:囊性脑膜瘤。讨论囊性脑膜瘤发病率很低,约占颅内脑膜瘤的2%￣4%。Carvalho[1]将其分为囊在瘤内和…     

恶性垂体腺瘤颅内种植1例报告

患者男性,69岁,1960年诊断:垂体腺瘤。曾在外院放疗3疗程,1987年行垂体瘤切除术。病理报告:嗜酸性垂体腺瘤。1998年复查CT发现颅内多个肿瘤,未治疗。2000年11月因意识障碍、左侧肢体瘫痪、大小便失禁入院。查体:嗜睡、言语错乱。下颌、额、眶明显突出,唇厚。右面部痛觉减弱。左侧肢体深、浅感觉减退,肌张力增高,肌力Ⅰ-Ⅱ级,左肱二、三头肌腱反射亢进,巴彬斯基征（±）。头颅CT、MRI示蝶鞍扩大,但鞍区未见肿块影;右额、颞、顶、枕及左颞部有多个肿瘤性包块,且较前明显增大,CT增强呈均匀高密度影,MRI呈短T1长T2表现。胸部CT、腹部B超等未见异常。术前诊断:多发性脑膜瘤?2000-11-28在全麻下行开颅探查肿瘤切除术,全切除肿瘤15个,分别位于右额镰旁1个,镰旁中央沟静脉前1     

鼻腔鼻窦异位脑膜瘤一例

异位脑膜瘤临床上较为少见，分为原发性和继发性两种，原发于鼻腔鼻窦的异位脑膜瘤罕见。目前对原发于颅脑外的异位脑膜瘤的组织来源未明确，本文对此例病例进行报道。     

胶质瘤术后放疗致脑膜瘤一例

患者男性,40岁,1994年发现左颞叶占位性病变,MR显示肿瘤大小约2.2 cm×2.0 cm×1.0 cm.行左颞开颅肿瘤切除术,术中全切肿瘤及周围组织共约5.0 cm×5.0 cm×4.0 cm,病理报告为星形细胞瘤Ⅰ级,术后患者恢复好,无后遗症状,予肿瘤部位补充放疗一疗程,每周5次,连续5周,总剂量5000 cGy.     

颅内类似脑膜瘤的腺样囊性癌一例报告

患者男性,43岁,因右侧眼眶肿痛2个月、加重1周入院,视物有重影,时有头晕、头痛.查体:右侧眼球明显突出.双侧眼球运动正常.视力无下降,视野无缺损.双瞳等大等圆,对光反射灵敏.头颅MRI显示右侧额部、右侧眼眶外侧壁及右侧眶内占位性病变,形态不规则,大小约4.5 cmx3.5cm×3 cm,呈等T1、稍长T2信号,右侧视神经受压;增强扫描后病灶呈明显异常强化,并可见局部脑膜强化(图1).头颅CT见眶外侧壁骨质受破坏(图2).术中见额角后颞肌下局部肌肉受侵犯,局部颅骨受破坏变软;咬除病变骨质后,见硬膜外肿瘤样增生物,质地较软,与硬膜粘连,但能分离:用微钻磨除额骨受侵蚀部分以及眶上板、眶外侧壁直至正常骨质,清除眶外侧增生物,暴露眶内容物.肿瘤全切,病理报告为腺样囊性癌.耳鼻喉科会诊未发现鼻咽部病变.术后嘱进一步行放射治疗,现随访中.