每日一题_2025.08.07

A previously healthy 47-year-old woman presented to the neurology clinic with a 1-month history of worsening headaches associated with blurry vision, galactorrhea, and irregular menstrual cycles. Physical examination was notable for reduced visual acuity of 20/50 in both eyes, with normal visual fields and extraocular movements. Magnetic resonance imaging (MRI) of the head showed a mass protruding from the sella turcica into the suprasellar cistern. Which of the following is the most likely diagnosis?

一名既往健康的47岁女性因头痛加重1个月伴视力模糊、溢乳及月经周期紊乱就诊于神经科门诊。体格检查发现双眼视力下降至20/50，视野及眼球运动正常。头颅磁共振成像显示鞍区占位向鞍上池突出。以下哪项是最可能的诊断？

A. Craniopharyngioma颅咽管瘤

B. Meningioma脑膜瘤

C. Pituitary macroadenoma垂体大腺瘤

D. Pituitary metastasis垂体转移瘤

E. Optic chiasmic astrocytoma视交叉星形细胞瘤

答案解析：

磁共振成像（MRI）结果显示，​垂体增大并压迫视交叉，形成“雪人征”​。同时可见垂体内出血。所谓“雪人征”，是指起源于鞍区的肿瘤在缓慢生长过程中，当其向上方扩展时，受到鞍膈（鞍顶）的压迫而形成的一种特殊形态——肿瘤上部分叉，形似雪人的头部与身体。患者接受了经蝶窦手术切除治疗。

正确答案：C