下垂体腫瘍摘出術後に脳膿瘍を形成した蝶形骨洞篩骨洞囊胞の1例

A Case of Paranasal Cyst with Brain Abscess Presenting Visual Loss in 23 Years after Trans-Sphenoid Surgery

I．はじめに

　経蝶形骨洞下垂体手術後には蝶形骨洞内に囊胞が生じる可能性がある。しかし，実際に蝶形骨洞内に囊胞が生じ外科的対応が必要となることは稀である^1）。

　今回われわれは，経蝶形骨洞下垂体手術23年後に視力障害で発症し，脳膿瘍の形成が認められた巨大な蝶形骨洞篩骨洞囊胞の1例を経験したので報告する。

　A patient received steroid therapy for visual disturbance,and her visual acuity was recovered.

　Then a small defect in the anterior skull base was found on plain brain CT,and a paranasal cyst was found on sinus CT. In addition a brain abscess was revealed by head MRI.

　The patient underwent trans-sphenoid surgery for hypophyeal tumor 23 years ago. Optic neuritis caused by rhinogenic origin should be considered at the first visit. We now understand that area of CT scan as well as choice of imaging modality is important for the correct diagnosis.