[A Case of Adenomatoid Odontogenic Tumor with Intracranial Extension]

A 49-year-old female of adenomatoid odontogenic tumor with intracranial extension was reported. She had 3 months history of left nasal obstruction and visual disturbance. Endocrinological examinations revealed a low basal level of serum cortisol and low level of urinary 17-OHCS. Neurological examinations revealed left anosmia and left visual disturbance (hand movement, marked afferent pupillary defect, and lower hemianopsia). Plain X-ray films and frontal tomograms of the skull showed a mass of soft tissue density in the left upper maxillary, left posterior ethmoid, and sphenoid sinuses with extensive destruction of the sella turcica, dorsum sellae, and anterior clinoid process. Plain axial CT scans demonstrated a low density mass filling up the left maxillary, left posterior ethmoid, and sphenoid sinuses and extending into the left middle fossa with bony destructions. Contrast-enhanced coronal CT scans demonstrated an extradural extension of the tumor into the left middle fossa and upward displacement of the pituitary complex. Left carotid angiograms showed a faint narrowing of the left internal carotid artery between the cisternal portion and the origin of the ophthalmic artery. Subtotal removal of the tumor and decompression of the optic canal and superior orbital fissure were performed via a left subtemporal extradural approach. Adenomatoid odontogenic tumor is a comparatively rare benign lesion which exhibits a slowly expansive growth without recurrence or metastasis after the surgical removal. No other case that recurred several times and extended into the intracranial space has been reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)