뇌하수체 선종으로 감마나이프 치료 시행 후 발생한 뇌하수체 상피양 골육종 1예
Pituitary Epithelioid Osteosarcoma after Gamma-knife Surgery of a Pituitary Adenoma
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본 증례는 수술 및 감마나이프 치료로 뇌하수체 선종을치료하고 추적 관찰 중이던 환자에서 13년 후 뇌하수체 상피양 골육종이 확인된 증례이다. 고전적 방사선 치료와 관련된이차성 종양의 발생에 대하여는 잘 알려져 있으나 상대적으로 저선량이 사용되는 정위적 방사선 치료에서는 이와 관련된 보고는 매우 드물다. 정위적 방사선 치료 후 발생하는 이차성 종양은 흔하지 않으나 임상 의사가 염두에 두어야 하는부작용 중 하나이므로 증례보고하는 바이다.
Abstract
With the increasing use of stereotactic radiosurgery, recent reports have suggested that stereotactic radiosurgery may induce secondary malignancies. While the risk of secondary malignancy after conventional radiotherapy is well known, its development after stereotactic radiosurgery has been reported in only a few cases. Here we present the case of a 56-year-old female with visual disturbance of sudden onset. She underwent trans-sphenoidal surgery for a pituitary adenoma 13 years earlier. Imaging studies revealed a newly developed pituitary mass invading the right carvenous sinus. Gross total resection of the tumor was performed using a trans-sphenoidal and pterygopalatine fossa approach. The histological diagnosis was pituitary epithelioid osteosarcoma. Clinicians should be aware of the rare occurrence of radiation-induced pituitary sarcoma as a potentially fatal late complication of stereotactic radiosurgery.
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