Sphenoidal sinus mucocele after transsphenoidal surgery for acromegaly |
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Authors: | L Kessler V Legaludec Jean Louis Dietemann Daniel Maitrot M Pinget |
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Institution: | Service d'Endocrinologie et Maladies Métaboliques, H?pital Central, 1 place de l'H?pital, 67091 Strasbourg Cédex, France, FR Department of Endocrinology, H?pital Universitaire, Strasbourg, France, FR Department of Radiology, H?pital Universitaire, Strasbourg, France, FR Department of Neurosurgery, H?pital Universitaire, Strasbourg, France, FR
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Abstract: | This report concerns one case of a sphenoid sinus mucocele occurring 17 years after transsphenoidal surgery for acromegaly.
In 1979, a 51-year-old man was successfully operated by the transnasal transsphenoidal approach for a growth hormone (GH)
adenoma 1 cm in diameter. In 1996, the patient was hospitalized for headaches and diplopia. He presented a loss of right visual
acuity with paralysis of the right oculomotor nerve. The basal GH level was normal with a satisfactory decrease after oral
glucose ingestion. Pituitary sellar radiography showed a disappearance of the posterior clinoid while magnetic resonance imaging
revealed the existence of a bilocular, circular, homogeneous lesion of the sphenoid sinus 3 cm in diameter with a posterior
and lateral extension. The diagnosis of mucocele was confirmed by surgical treatment, allowing drainage of the mucocele through
a transsphenoidal approach. The drained material was composed of sinus epithelium containing many polynuclear and resorptive
cells. Postoperatively, the symptoms decreased dramatically, leading to full recovery of visual function and disappearance
of the headaches. Apart from the tumor recurrence, the mucocele of the sphenoid sinus can be evoked as a possible long term
complication of transsphenoidal sugery for pituitary adenoma.
Received: 2 June 1998 / Accepted: 23 February 1999 |
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Keywords: | Sphenoidal sinus ⋅ Mucocele ⋅ Acromegaly ⋅ Transsphenoidal surgery ⋅ Pituitary surgery |
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