UNASSIGNED: A 28-year-old woman presented to the clinic with a 2-week history of headaches, blurred vision, nausea, and vomiting. She had no medical or surgical history, no signs of hormonal disturbances, and no family history of brain tumors or endocrine diseases. Her neurological examination was unremarkable except for bitemporal hemianopia on visual field testing. A magnetic resonance imaging of the brain showed a cystic mass in the sellar region that was compressing the optic chiasm with radiological features representing cystic craniopharyngioma. She underwent endoscopic transnasal transsphenoidal surgery to excise the mass, and only subtotal excision was achieved to preserve the pituitary function. The histopathology confirmed the diagnosis of a xanthogranuloma of the sellar region. The postoperative course was unremarkable, and she did not receive any adjuvant therapy. There was no recurrence of the clinical symptoms or the mass during the 18-month follow-up period.
UNASSIGNED: Although xanthogranuloma is uncommon, it should be included in the differential diagnosis of sellar/suprasellar lesions. Due to its wide range of radiological features that sometimes can mimic other lesions, a definitive diagnosis can only be made postoperatively. Surgical excision is the most accepted treatment with a favorable prognosis and low rates of recurrence.
一位28岁的女性出现在诊所,有2周的头痛史,视力模糊,恶心,和呕吐。她没有病史或手术史,没有荷尔蒙紊乱的迹象,无脑肿瘤及内分泌疾病家族史。除了视野测试中的双颞侧偏视外,她的神经系统检查并不明显。大脑的磁共振成像显示,鞍区有一个囊性肿块,正在压迫视交叉,具有代表囊性颅咽管瘤的放射学特征。她接受了鼻内镜经鼻蝶手术切除肿块,只有次全切除才能保持垂体功能。组织病理学证实了鞍区黄色肉芽肿的诊断。术后病程不明显,她没有接受任何辅助治疗。在18个月的随访期内,临床症状或肿块均未复发。
■虽然黄色肉芽肿并不常见,应将其纳入鞍区/鞍上病变的鉴别诊断。由于其广泛的放射学特征,有时可以模仿其他病变,只有在术后才能做出明确的诊断.手术切除是最被接受的治疗方法,预后良好,复发率低。