| 摘要 |
Background: Symptomatic neurohypophyseal granular cell tumors (GCTs) are
rare, and their main presenting symptoms are usually nonspecific. Rarely,
neurohypophyseal GCTs manifest intratumoral bleeding.
Case Description: A 77year-old woman presented with a 2-year history of
headache and blurred vision, and sudden onset of visual disturbance one week
before. Neurologically, she had constricted visual fields and endocrine studies
revealed pituitary dysfunction. Brain computed tomography showed a hyperdense
pituitary lesion with suprasellar extension, and magnetic resonance imaging
demonstrated a pituitary tumor with a mixed isointense and hyperintense center
surrounded by a hypointense rim on both T1 and T2 images. The tumor had mild
heterogeneous enhancement at the center and linear enhancement at the margin.
Subtotal tumor excision via the transsphenoidal approach was performed and
nonclotted blood was found in the tumor. The postoperative course was complicated
with meningitis and diabetes insipidus. After treatment with antibiotics and
pitressin, her condition stabilized and her vision improved. Pathology revealed a
granular cell tumor with bleeding. After 18 months of follow up, she was doing well
with regular hormone replacement therapy. The patient refused radiotherapy for
her residual tumor.
Conclusion: Neurohypophyseal granular cell tumor rarely manifested as
intratumoral bleeding. We present the clinical features of this patient and review the
literature. |
