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Brain and Nerve No to Shinkei Volume 24, Issue 6 （June 1972）

Brain and Nerve 脳と神経 24巻6号（1972年6月発行）

Japanese English

症例報告

下垂体腺腫のNasopharyngeal extension—そのMechanismに対する考察 NASOPHARYNGEAL EXTENSION OF THE PITUITARY ADENOMA 福村昭信 ¹ , 松角康彦 ¹ , 定永正明 ² Akinobu Fukumura ¹ , Yasuhiko Matsukado ¹ , Masaaki Sadanaga ² ¹熊本大学医学部脳神経外科 ²熊本大学医学部耳鼻咽喉科 ¹Department of Neurosurgery, Kumamoto University Medical School ²Department of Otorhinolaryngology, Kumamoto University Medical School pp.725-731

発行日 1972年6月1日 Published Date 1972/6/1

DOI https://doi.org/10.11477/mf.1406203133

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Abstract 文献概要
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Ｉ．はじめに

　下垂体腺腫が頭蓋底を破壊して鼻咽腟に露出してくることは珍しいことで，ことに最近のように診断技術が進歩した現在では極めてまれな現象と考えられ，1933年のSalus^15）の報告以来現在までわずかに15例が記載されているにすぎない（第1表）。わが国では景山^5），桑原^9）が行なつた下垂体腺腫に関する多数の症例の統計にnaso—pharyngeal extensionがふれられておらず，このような症例はなかつたものと推定される。

　下垂体腺腫が頭蓋底を破りnasopharyngeal extensionを示すことは，臨床的に悪性腫瘍とみなされるべきであるが，組織学的に必ずしも悪性ではなく悪性下垂体腺腫と記載されたものは報告例15例のうち4例に認められているにすぎない。

Nasopharyngeal extension of a pituitary adenoma is rare and since 1933, 15 cases were reported on the literature. It is our purpose to add one of such cases here and to compare with carefully examined 9 cases previously reported.

A 54-year-old woman was admitted to our Depart-ment with frontal pain and strange snore. On admission neurological and endocrinological exami-nations were unremarkable and no visual distur-bance was encountered, however, plain skull tomo-gram revealed destruction of the sellar floor and a round shaped tumor shadow in the nasopharyngeal airway. Pneumoencephalogram disclosed also sup-rasellar growth of the tumor to some extent. ENT examination revealed a dark-reddish solid polyp in the nasopharyngeal region. A biopsy of the polyp was made and the histological report of which was chromophobe adenoma. Via rhinoseptal transphenoidal approach total removal of the naso-pharyngeal polyp and intracapsulary partial resec-tion of the tumor were performed. Histological diagnosis of the tumors showed no evidence of malignancy. The postoperative course was un-eventful and moderate dosis of Linac irradiation (3,400 r) was applied in order to prevent postopera-tive c. s. f. rhinorrhea. One year and eight months follow-up revealed no specific complaints.

Emphasis was placed on the clinical history of present case which did not show any contributory features as previously reported, such as visual dis-turbance, evidence of parasellar extension or histo-logical malignancy. Mechanism of infrasellar tumor extension was discussed in regards to anatomical structure of the sella turcica.