蝶形骨洞篩骨洞嚢胞，下垂体腫瘍の合併例

A Case of Sphenoethmoidal Mucocele Combined with Pituitary Adenoma

I．緒言

　蝶形骨洞嚢胞は他の副鼻腔嚢胞に比しその発生頻度は低く，またその進展とともにトルコ鞍，眼窩，視神経管，上眼窩裂などに近いという解剖学的位置と関連して種々の脳神経症状を呈することが多く，眼症状，頭痛などが前最に立ち，鼻科的診断がないと頭蓋内疾患とくにトルコ鞍近傍腫瘍とときに誤られることが指摘^4,9）されている。今回われわれは両側篩骨洞蝶形骨洞が一つに融合した巨大な嚢胞と下垂体腺腫の合併という非常に稀な症例を経験したので，文献的考察を加え報告する。

　In a 68-year-old female a sphenoidal mucocele combined with pituitary adenoma was found. She had a history of exophthalmos, migraine, disturbance of visual acuity and eye movement. This patient was referred to a neurosurgeon because of long-term eye symptoms and headache, and pituitary adenoma was suspected. On the other hand, bilateral sphenoethmoidal mucocele was also pointed out. This case was thought to be a very rare case having two lesions combined. The pituitary adenoma was removed neurosurgically and then the mucocele was removed otorhinologically, and her symptoms became markedly alleviated. Thus we stressed that when these symptoms are encountered it is important to investigate from the standpoints of both neurosurgery and otorhinology.