超高齢非機能性下垂体腺腫に対する外科治療

The Surgical Treatment of Non-functioning Pituitary Adenomas in the Ninth Decade

Ⅰ．はじめに

　高齢下垂体腺腫患者に対する外科治療についての報告は散見^3,5,8-10)されるが，高齢下垂体腺腫患者は他の全身疾患を多く有することなどから，手術侵襲による全身状態の悪化を危惧して経過観察を選択することも多いと考えられる．しかし，視力障害の愁訴をもつ高齢下垂体腺腫患者に対して，外科治療適応を考慮する必要性があることも事実である．今回われわれは，視力障害にて発症した超高齢者の非機能性下垂体腺腫の3手術例を経験し良好な結果を得たので，その治療経過について報告する．

　There are no reports of surgical treatment for non-functioning pituitary adenomas in the 9th decade of life, and it is thought that these patients often select conservative treatment and observation, because of their worry about deterioration of their general condition due to invasive surgery and because hypopituitarism and other medical problems are often present. However, it is also true that there is necessity for considering surgical treatment for the pituitary adenomas even in the 9th decade when there is a complaint of visual disturbance. We carried out the palliative surgical removal of three non-functioning pituitary adenomas with visual disturbance in the 9th decade and report these surgical treatments and outcomes. The improvement of visual disturbance was obtained in all three cases. The only perioperative complication was pneumothorax caused by barotrauma. The palliative transsphenoidal surgical removal of non-functioning pituitary adenomas for the purpose of improvement of visual disturbance is a safe procedure in the 9th decade of life.