- 期刊
Incidentally Found Pituitary Macroadenoma Presenting as Primary Tumor Arising from Sphenoid Sinus during F-18 FDG PET/CT Imaging
偶然發現的腦下垂體大腺瘤在影像上呈現蝶竇的原發腫瘤
摘要
腦下垂體偶然發現的腫瘤大多為腺瘤。依大小分為小腺瘤（microadenoma，小於10 mm）、大腺瘤（macroadenoma，大於10 mm）及巨大腺瘤（giant adenoma，大於40 mm）。侵襲性腦下垂體腺瘤是指周圍的結構被腺瘤侵襲。我們提出一位曾有子宮內膜癌既往症的70歲女性，在氟18去氧葡萄糖正子全身掃描時偶然發現蝶竇有高葡萄糖代謝的病灶，向上延伸至腦下垂體窩處。MRI影像中可見腫瘤主要中心點位於蝶竇而且壓迫正常腦下垂體向左側移位。鑑別診斷包括異位腦下垂體腺瘤位於蝶竇（正常腦下垂體仍存在）、原發於蝶竇的腫瘤（例如神經內分泌瘤等）、有不典型表現的腦下垂體腺瘤、脊索瘤、轉移性癌症等等。經蝶切除術後，病理診斷為腺瘤。
並列摘要
Most pituitary incidentalomas are adenomas. They are classified as microadenoma (＜ 10 mm), macroadenoma (＞ 10 mm) and giant pituitary adenoma (＞ 40 mm). Invasive pituitary adenoma means the surrounding structures are invaded. We present an incidentally found hypermetabolic lesion at sphenoid sinus with the upper portion extending into pituitary fossa during F-18 FDG PET/CT imaging in an asymptomatic 70 year-old female with history of uterine endometrioid adenocarcinoma. MRI revealed the tumor epicenter at sphenoid sinus and normal pituitary gland was displaced laterally. The differential diagnosis included ectopic sphenoid sinus pituitary adenoma (with normal anterior pituitary gland), pituitary adenoma with atypical manifestation, primary tumor arising from sphenoid sinus (e.g., neuroendocrine tumor), chordoma, and metastasis, etc. Pathology revealed pituitary adenoma after Trans-sphenoidal resection.