被誤診為中心性網膜炎之海綿竇脊索瘤之一例

A case of chordoma which was misdiagnosed as a central retinitis in a 37 year-old male was presented. The chordoma is a very rare congenital tumor of rather low malignancy and grows very slowly. It arises from notochordal remnants over the dorsum sellae or at the junction of the sphenoid and occipital bone. It is also found in the lumbosacral region of the spinal cord. It is highly invasive and spreading along the base of the skull in all directions. Routine ophthalmological examinations were performed. Because of blurring of vision with the dirty macula, central retinitis was suspected. But detailed studies of skull X-ray showed pituitary tumor and visual field examination revealed bitemporal inferior quadrantanopsia, which associated with ocular symptoms and signs. So under impression of chiasmal lesion the patient was transferred to the neurosurgeon. Craniotomy and removal of the tumor tissue was done. Pathological diagnosis revealed as CHORDOMA. The importance of visual field examination and skull X-ray study were emphasized.

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