[A case of suprasellar tumor associated with so-called atypical angina pectoris]

A case of suprasellar tumor associated with so-called atypical angina pectoris was reported. A 58-year-old man was admitted to our hospital on Feb. 2, 1973, because of headache, disturbance of visual field and the attack of chest pain. He had been suffering from disturbance of visual field for about 3 years and the attack of chest pain for about 4 months prior to admission. Neurological findings on admission were bitemporal hemianopia, decreased visual acuity and atrophy of the optic disc. Bilateral carotid angiography showed upward displacement of A1 portion of the anterior cerebral artery. Pneumoencephalography demonstrated defect of the anterior part of the third ventricle. Laboratory examination showed hypopituitalism. On March 26, 1973, Right frontal craniotomy was performed under the diagnosis of suprasellar tumor. The walnut-sized tumor was detected in the suprasellar region and removed totally. Histological examination showed dermoid cyst. With regard to the attack of chest pain, the selective coronary angiography was performed. But organic change was not detected and Master's two step test did not induce any pathological finding in EEG. So we made a diagnosis of so-called atypical angina pectoris. There are many arguments about pathogenesis of so-called atypical angina pectoris. There is no organic change of the heart of attention now. Recently it is said that so-called atypical angina pectoris is closely connected with paradoxical sleep. We recognized dysunction of the autonomic nervous system through various examinations. The hypothalamus was displaced upward by a suprasellar tumor in this case. After removal of the suprasellar tumor, the frequency of the attack of chest pain was decreased. The atypical angina pectoris in the presented case may be considered to consequence of distrubance of the hypothalamic function.