Prolactinomaの放射線治療後に発生したトルコ鞍部線維肉腫

Sellar Fibrosarcoma following Radiotherapy for Prolactinoma

I．緒言

　1959年Terryら^21）が下垂体腺腫の放射線治療後に発生した下垂体部線維肉腫の3例を報告して以来，同様の報告が相つぎ，下垂体腺腫に対する放射線治療の遅発性副作用のひとつとして注目を集めている．

　最近われわれは，invasive prolactimmaの女性例で，54歳時に腫瘍部分摘出術と引き続く総量5,000radのLineac照射を受け，2年余を経て下垂体部線維肉腫の発生をみた症例を経験した．本症例の詳細について報告するとともに，文献上20例の放射線照射後下垂体部肉腫発生例を検討し，下垂体腺腫の放射線療法について若干の考察を加える．

A 51-year-old house woman visited the Departmentof Neurosurgery, Osaka University Hospital forexamination of the head injury on Oct. 7, 1975.Neurological examination was normal. Endocrinolo-gical examination showed galactorrhea. The patienthad a past history of premature menopause. Plainskull films revealed enlargement of sella turcica andCT scan showed sellar tumor with suprasellar expansionwhich was enhanced by contrast medium. The serumprolactin (PRL) level was 3,290 ng/ml. Diagnosisof PRL secreting pituitary adenoma (prolactinoma)was made. Though surgical removal of the tumor wasrecommended, it was refused by the patient.