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垂体脓肿术前不易与垂体腺瘤相鉴别,由于较为罕见,增加了诊断上的困难。我院于1980年收治1例垂体脓肿,术前误诊为垂体腺瘤,现报道于下。 患者,男,59岁。主诉头痛,视力减退7个月。于1980年7月3日入院。患者无明显诱因,头痛近半年,以右侧为著,呈持续性钝痛,头部摆动或变换体位时感颅内有“咕噜”声。无恶心、呕吐及发热。视力逐渐下降,右眼颞侧下降明显,曾在他院按眼底病治疗无效。同时无意中发现两侧颧骨隆起,鼻子增大,嘴唇增厚,手指足趾变粗。既往常患感冒,无中耳炎及副鼻窦炎病史。检查:神清,四肢呈典型的肢端肥大,双侧瞳孔同大等圆,对光反射存在。双侧视神经乳头苍白,以右侧较重。视力:左眼0.6,右眼0.1。视野:左眼基本正常,右眼颞侧缺损。无定位体征。颅骨X线平片:蝶鞍明显扩大(前后径35mm,深22mm),鞍底骨质明显破坏并吸收,鞍区无钙斑,乳
Pituitary abscesses are not easily differentiated from pituitary adenomas before surgery because they are rare and increase the diagnostic difficulties. Our hospital received a case of pituitary abscess in 1980 and was misdiagnosed as pituitary adenoma before surgery. It is reported below. Patient, male, 59 years old. He complained of a headache and his vision deteriorated for 7 months. Admitted to hospital on July 3, 1980. The patient had no obvious incentives. He experienced a headache for the first half of the year. The right side of the head had a persistent dull pain. When the head oscillates or changes his position, he feels a fluctuating cranial sound. No nausea, vomiting and fever. The visual acuity gradually decreased, and the right eye’s temporal descended significantly. He had been treated with eyeground disease in his hospital. At the same time, they unwittingly discovered that both sides of the tibia were uplifted, their noses were enlarged, their lips thickened, and their toes were thickened. I used to have a cold, no otitis media, and a history of paranasal sinusitis. Examination: Shen Qing, typical extremity hypertrophy of the extremities, bilateral pupils equal to large circles, presence of light reflexes. The bilateral optic nerve head is pale and heavy on the right side. Vision: 0.6 in the left eye and 0.1 in the right eye. Field of vision: The left eye is normal and the right eye has a radial defect. No location signs. Skull X-ray: Scalp significantly enlarged (anterior and posterior diameter 35mm, depth 22mm), saddle bottom bone destruction and absorption, saddle area without calcium plaque, milk