鞍区颗粒细胞瘤1例的病历分析及相关文献复习

A Case Report of Granular Cell tumour of the Sellar and Suprasellar Region and Literature Review

目的:探讨伴有临床症状的鞍区颗粒细胞瘤(granular cell tumour,GCT)的病理组织学起源及其治疗方法。方法:回顾性分析我院收治的1例具有临床症状的GCT患者的治疗状况和病理结果,并结合近20年来关于GCT病理和治疗的相关文献报道,探讨GCT肿瘤病理组织起源和治疗要点。结果:该患者影像学报告怀疑鞍区炎性肉芽肿,给予抗生素治疗后复查MRI显示鞍区占位较前次无改变,增强MRI可见占位明显强化,诊断良性肿瘤,并采取翼点入路手术切除。术后病理证实为神经垂体颗粒细胞瘤。术后患者头痛缓解,尿量、尿比重、垂体内分泌激素等相关指标相继恢复至正常值。结论:GCT很可能起源于神经组织,伴有临床症状的GCT的治疗首选开颅手术,肿瘤残存的患者,术后不必放射治疗,定期复查即可。

Objective： To Discuss the histologic origin and treatment of granular cell tumour（GCT） of the Sellar and Suprasellar Region with clinical symptoms. Methods： The treatment and pathology of 1 patient of GCT with clinical symptoms in our hospital was retrospectively analyzed, and the treatment and pathology of GCT with clinical symptoms which had been reported in the past 20 years were reviewed. Results： Primarily, the imaging result of the patient was suspected the inflammatory granuloma saddle area. After the treatment by the antibiotics for 15 days, the magnetic resonance imaging（MRI） showed that there was a saddle area placeholder than previous one, and the enhanced MRI presented the visible placeholder have significantly strengthened, which was prone to confirmed the benign tumor. Then the pterional surgery was performed. The case was confirmed the neurohypophysis granulosa cell tumor by postoperative pathology. The related indexes which includes the headache relief, the urine＇s specific gravity, the pituitary endocrine hormone and others were much better than before.Conclusion： GCT probably originates from nerve tissue. The best treatment for the GCT with clinical symptoms is the craniotomy treatment. Residual tumor patients need regular reexamination but radiotherapy is no necessary for them.