Anterior view of the pituitary gland (zhang Xiaoquan painting)
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Adolescent girls "menstrual disorders" for more than 2 years, but also appeared vision loss, dizziness, nausea, and even fainted for no reason, all because of a tumor in her head. A few days ago, neurosurgery experts from Hunan Provincial People's Hospital successfully surgically removed this "time bomb" for her.
Preoperative head CT and MRI show that the tumor in the saddle area (within the red circle) is larger than a ping-pong ball and compresses important nerves and blood vessels around it.
Xiaowen (pseudonym), a 19-year-old native of Miluo, Hunan, began to have an extended menstrual cycle about 2 years ago, and only came to menstrual leave every two or three months; in the past year, the "big aunt" simply did not come, and was diagnosed with "menstrual disorders" in the hospital. After taking the medicine prescribed by the doctor, there was a menstrual holiday; but as long as the drug was stopped, the "great aunt" did not come again. A month ago, Xiaowen's eyesight became poor, she looked at her phone vaguely, and she also had dizziness, headache, nausea, vomiting, fatigue and even fainting. Doing a head CT at the local hospital found that there was a tumor in the head!
View under the pituitary handle (zhang Xiaoquan painting)
On November 8, 2021, Accompanied by her family, Xiaowen went to the Tianxin Pavilion Branch of Hunan Provincial People's Hospital for treatment. After examining the CT film, Chief Physician Huang Mengyi of the Department of Neurosurgeryngeal Surgery made a preliminary diagnosis of "craniopharyngioma" and admitted her to the ward of the Department of Neurology.
Further examination after admission found that the tumor was about 4.5 × 4.4 ×4 .6cm, larger than a ping-pong ball, surrounded by important nerves and blood vessels such as the internal carotid artery, optic nerve, three ventricle floors, cavernous sinuses, pituitary gland, pituitary stalk, etc.
Doctors told Xiaowen and her family that because the tumor compressed the optic nerve, it caused her vision to lose, and also compressed the pituitary gland, resulting in her endocrine disorders, menstrual disorders, and the formation of cranial hypertension. If surgery is not performed as soon as possible, the disease may continue to progress and be life-threatening.
Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei performed microscopic craniopharyngioma resection surgery for patients through the endplate pool approach.
The preoperative discussion in the surgical group believes that because the tumor is wrapped in the optic nerve, internal carotid artery, oculomotor nerve, pituitary gland, etc., once these important nerves and blood vessels are damaged during the operation, it may lead to irreversible sequelae. Through three-dimensional reconstruction and surgical exercises, Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei estimated the difficulties that may be encountered during surgery and formulated corresponding countermeasures.
On November 22, Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei performed microscopic craniopharyngioma resection for Xiaowen under general anesthesia, and successfully removed this "time bomb". On the fourth day after the operation, Xiaowen was able to eat normally, and on the sixth day after the operation, she was transferred back to the general ward and was discharged from the hospital on December 13.
Postoperative head CT shows that the tumor in the saddle area is basically removed. (The area of surgery is within the red circle)
"Craniopharyngioma is a benign tumor of the central nervous system located in the saddle or parasellar region", said Chief Physician Huang Mengyi, craniopharyngioma is a common non-glial cell tumor in children and adolescents, with a high incidence of 5 to 15 years old, accounting for 54% of intracranial tumors in this age group. Because the early symptoms of the disease are not obvious, often when the head hypertension develops, the cause of the head will be considered and then investigated, and irreversible damage often occurs at this time.
In this regard, Huang Mengyi reminded that if children have repeated headaches, short stature, polyuria, obesity, genital development retardation and other manifestations of hypopituitarism in the process of growth and development, they should undergo a systematic examination to find or exclude craniopharyngioma as soon as possible, so as to achieve early detection, early diagnosis and early treatment.
Before being discharged from the hospital, Xiaowen and her family praised the provincial medical neurosurgery team.
Text: Liang Hui Zhang Xiaoquan
Editor: Liang Hui
Review: Zhou Jinrong