Güçlü Kaan BERİAT, Cem DOĞAN, Şefik Halit AKMANSU, Demet KARADAĞ, Handan DOĞAN

Nadir bir burun tıkanıklığı nedeni: Dev invaziv nonfonksiyonel hipofiz adenomu

Burun tıkanıklğı hipofiz adenomun neden olduğu çok nadir bir semptomdur. Elli yedi yaşında erkek hasta altı aydır süren iki taraflı burun tıkanıklığı ile kliniğimize başvurdu. Endoskopik muayenesinde her iki burun boşluğunda yumuşak pembemsi, pul- satil doku izlendi. Radyolojik incelemelerinde frontal loba, sfeno-ethmoidal sinüslere ve burun boşluk- larına uzanım gösteren suprasellar kitle izlendi. Hastada bitemporal üst kadran hemianopsi vardı. Hipofiz hormon düzeyleri normal idi. Biyopsiler has- tadan endonazal yol ile alındı. Patolojik değerlendir- mesi ve laboratuvar bulguları nonfonksiyonel hipofiz adenomu ile uyumluydu

Anahtar Kelimeler:

Biyopsi, burun tıkanıklığı, hipofiz adenomu

A rare cause of nasal obstruction: giant invasive nonfunctioning pituitary adenoma

Nasal obstruction is a very rare symptom caused by a pituitary adenoma. A 57-year-old man admitted to our clinic with bilateral nasal obstruction for the last six months. Endoscopic examination revealed soft pinkish pulsatile tissues in both nasal cavities. Radiologic investigation revealed a suprasellar mass extending to the frontal lobes, spheno-ethmoidal sinuses and nasal cavities. He had bitemporal superior quadrant hemianopsia. Pituitary hormone levels were normal. Biopsies were taken from the patient endonasally. Pathological evaluations and laboratory findings were compatible with nonfunctioning pituitary adenoma.

Keywords:

Biopsy, nasal obstruction, pituitary adenoma,

PDF

___

Burger PC, Scheithauer BW, Vogel FS. Region of the sella turcica. In: Burger PC, Scheithauer BV, Vogel FS, editors. Surgical pathology of the nervous system and its coverings. 4th ed. New York: Churchill Livingstone; 2002. p. 437-97.
Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML, et al. The prevalence of pituitary adenomas: a systematic review. Cancer 2004;101:613-9.
Asa SL. Practical pituitary pathology: what does the pathologist need to know? Arch Pathol Lab Med 2008;132:1231-40.
Isselbacher KJ, Eugene B, Wilson JD, Martin JB, Anthony SF, Kasper DL. Endocrinology and metabo- lism. In: Fauci AS, Braunwald E, Wilson JD, Harrison TR, editors. Harrison’s Principles of Internal Medicine. 14th ed. New York: Mc-Graw Hil; 1998. p. 917-78.
Godey B, Morandi X, Le Gall F, Feat S, Brassier G, Le Clech G. Pituitary adenomas with infra-sellar exten- sion into the nasopharynx. J Laryngol Otol 1999; 113:1109-11.
van der Mey AG, van Seters AP, van Krieken JH, Vielvoye J, van Dulken H, Hulshof JH. Large pitu- itary adenomas with extension into the nasopharynx. Report of three cases with a review of the literature. Ann Otol Rhinol Laryngol 1989;98:618-24.
Nelson PB, Goodman ML, Flickenger JC, Richardson DW, Robinson AG. Endocrine function in patients with large pituitary tumors treated with operative decompression and radiation therapy. Neurosurgery 1989;24:398-400.
Biousse V, Newman NJ, Oyesiku NM. Precipitating factors in pituitary apoplexy. J Neurol Neurosurg Psychiatry 2001;71:542-5.
Mikhael MA, Ciric IS. MR imaging of pituitary tumors before and after surgical and/or medical treatment. J Comput Assist Tomogr 1988;12:441-5.
Scheithauer BW, Kovacs KT, Laws ER Jr, Randall RV. Pathology of invasive pituitary tumors with special reference to functional classification. J Neurosurg 1986;65:733-44.
Evans CO, Young AN, Brown MR, Brat DJ, Parks JS, Neish AS, et al. Novel patterns of gene expression in pituitary adenomas identified by complementary deoxyribonucleic acid microarrays and quantitative reverse transcription-polymerase chain reaction. J Clin Endocrinol Metab 2001;86:3097-107.
Marcou Y, Plowman PN. Stereotactic radiosurgery for pituitary adenomas. Trends Endocrinol Metab 2000;11:132-7.
Becker G, Kocher M, Kortmann RD, Paulsen F, Jeremic B, Müller RP, et al. Radiation therapy in the mul- timodal treatment approach of pituitary adenoma. Strahlenther Onkol 2002;178:173-86.