鼻副鼻腔に進展した下垂体腫瘍症例

Pituitary adenoma invading the paranasal sinus and the nasal cavity

Ⅰ　はじめに

　下垂体腺腫は下垂体前葉に発生する良性腫瘍であり，脳神経外科領域において，比較的頻度の高い良性腫瘍である。しかし，頭蓋外に発生，進展する症例は稀であり，鼻副鼻腔領域での報告は少ない。一般的にその病理診断は容易であるが，周囲に広く浸潤する場合には，他の悪性腫瘍との鑑別が必要である^1）。今回われわれは，鼻副鼻腔に進展した下垂体腺腫2症例を経験したので報告する。

　Pituitary adenoma presenting with infra-sellar extension into the sphenoidal sinus are frequent,but extension to the nasal cavity and nasopharynx is very rare. We report herein two cases of pituitary adenomas in which the initial clinical signs were unconsciousness and visual disturbance. CT and MRI showed bone defect at the base of the frontal skull base and giant pituitary adenoma invading the nasal cavity. Intranasal endoscopic biopsy was performed and the diagnoses were made by histological examination and measurement of serum hormone levels. Patients were treated for resction of tumors by neurosurgeon. We thought that it is important to consider skull base tumors,if patients have nasal cavity masses with optical disorders.