论文部分内容阅读
男性,28岁。6岁时因头痛,淡漠,性格改变入院。神经系统正常。双侧颈动脉造影和气脑造影显示鞍上2.5cm 占位病变。右额开颅行肿瘤部分切除和囊腔引流,病理结果证实为颅咽管瘤。术后放疗(钴60 2800rad),其间又第二次手术部分切除肿瘤。尽管手术和收疗,但是患者病情进行性加重,左眼失明,右眼颞侧偏盲。8岁时被迫行第三次手术,肿瘤全切和垂体切除。术后垂体功能低下和癫痫,使用激素替代疗法和抗癫痫治疗。术后第5、7和9年复查CT 未见肿瘤复发。术后21年随访时,患者主诉额、枕部间断性疼痛,复查CT 和MR,可见右额硬膜外3.5CM 囊性占位,伴部分钙化。再行右额开颅切除
Male, 28 years old. At the age of 6, he was admitted to hospital because of headache, indifference, and personality changes. The nervous system is normal. Bilateral carotid angiography and gas brain angiography showed a 2.5cm lesion in the suprasellar region. The right frontal craniotomy performed partial tumor resection and cystic drainage. Pathological findings confirmed craniopharyngioma. Postoperative radiotherapy (cobalt 60 2800 rad), during which a second operation partially resected the tumor. In spite of surgery and treatment, the patient’s condition worsened, blindness of the left eye and hemianopia of the right eye. At the age of eight, she was forced to undergo a third operation with total tumor and pituitary resection. Postoperative pituitary hypofunction and epilepsy, hormone replacement therapy and antiepileptic treatment. There was no recurrence of CT in the 5th, 7th and 9th year of postoperative CT examination. During the 21-year follow-up, the patient complained of pain in the frontal and occipital disarticulations. CT and MR were reexamined. There was a 3.5 cm cystic space occupying right epidural space with partial calcification. Resection of right frontal craniotomy