鞍区黄色肉芽肿病例分析并文献复习

目的探讨鞍区黄色肉芽肿的诊断、治疗及预后。方法回顾性分析1例鞍区黄色肉芽肿病例的临床资料,病人术前头痛,右眼视力0.8,内分泌检查提示甲状腺功能低下,其他未见异常。显微镜下肿瘤全切。结合文献分析该病的临床表现、病理、影像学特点及治疗措施。结果病人术后头痛症状消失,视力好转,垂体功能低下无改善,并发尿崩症。3个月后复查未见肿瘤复发,但垂体功能低下及尿崩症仍未消失,需要长期激素替代治疗。结论鞍区黄色肉芽肿是一种罕见的颅内良性肿瘤,术前诊断困难,手术是首选治疗方式,复发少见,但常并发垂体功能低下。

Xanthogranuloma in the sella region: case analysis and literature review

Objective To explore the diagnosis,treatment and prognosis of xanthogranuloma in the sellar region.Methods Clinical data of one patient with xanthogranuloma in the sellar region was analyzed retrospectively.The preoperative symptoms were headache and hypopsia,with the visual acuity of his right eye being 0.8.Endocrine examinations before operation showed hypothyroidism without other hormone deficiency.Gross total resection of the tumor was performed under surgical microscope.The clinical presentations,pathological findings,imaging characteristics and treatment strategies were analyzed with literatures.Results The symptoms of headache disappeared and visual acuity improved after surgery,but the hypopituitarism had no improvement and the patient complicated with diabetes insipidus.In follow-up of 3 months,no recurrence occurred,but hypopituitarism and diabetes insipidus did not disappear,so long-term hormone replacement therapy was still required.Conclusions Xanthogranuloma in the sellar region is a very rare benign brain tumor with low rate of recurrence after operation,but preoperative diagnosis is difficult.Surgery is the optimal treatment for this disease,but hypopituitarism is common.