Primary Skull Base Carcinoid Tumor: A Case Report

原發性顱底部類癌腫瘤：病例報告

顏至謙(Chih-Chien Yen) ； 龍威任(Vei-Zein Long) ； 陳毓堃(Yue-Quen Chen) ； 奚聖川(Heng-Chuan Hsi)

《南臺灣醫學雜誌》 5卷1期 (2009/04) Pp. 26-30

https://doi.org/10.6726/MJST.200904_5(1).0005

摘要

原發性顱底部類癌腫瘤是極為罕見的。我們提出了一個關於原發性顱底部類癌腫瘤的案例。一名47歲女性在入院前六個月內斷斷續續發生劇烈頭痛合併有嘔吐的現象。腦部電腦斷層掃描指出在中央顱底部有一7公分大小廣泛性腫瘤侵犯到蝶竇及篩竇。此病人接受了經蝶竇內視鏡手術取得組織切片後診斷為類癌腫瘤。由於腫瘤無法藉由手術完全切除，此病人僅接受緩解治療。此病人接受了每日1格雷每週七日為期三週共21格雷的放射線治療。此個案報告證實原發性的類癌腫瘤會發生在中央顱底部，因此須放入顱底部腫瘤的鑑別診斷中。因為沒有特別的影像學技術可以正確診斷類癌腫瘤，組織學切片往往是必須執行的。對於類癌腫瘤的早期診斷及完全性的手術切除是重要的。

關鍵字

類癌腫瘤 ； 顱底部腫瘤 ； 原發性顱底部類癌腫瘤

並列摘要

Primary skull base carcinoid tumor is extremely rare. We report a case of a primary skull base carcinoid tumor. A 47-year-old female experienced intermittent severe headache associated with vomiting for 6 months prior to admission. A cranial computed tomography (CT) scan demonstrated an extensive central skull base tumor (70 mm in size) which invaded into the sphenoid sinus and ethmoid sinus. The patient underwent trans-sphenoid endoscopic surgery for tissue biopsy which led to the diagnosis of carcinoid tumor. Due to the difficulty of achieving complete surgical removal of the tumor, the patient was discharged with palliative treatment. She received radiotherapy with 21 x 1 Gy given in 3 weeks (1 Gy fractions per day and seven Gy fractions per week). This case report demonstrates that primary carcinoid tumors may arise in the central skull base, and therefore should be included in the differential diagnosis of central skull base tumors. No single imaging technique can provide a specific histologic diagnosis of carcinoid tumor thus biopsy is necessary. Early diagnosis and complete surgical removal of tumor is important.

並列關鍵字

carcinoid tumor ； skull base tumor ； primary skull base carcinoid tumor