Pituitary carcinomas: review of the current literature and report of atypical case

Introduction: Pituitary carcinomas are poorly understood, rare entities. They are distinguished from adenomas not by histopathological features but rather by the presence of metastases. Objective: We discuss the diagnosis, mechanism of dissemination and pathogenesis based on a review of the literatu...

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Bibliographic Details
Published in:British journal of neurosurgery 2020-10, Vol.34 (5), p.528-533
Main Authors: Todeschini, Alexandre B., Beer-Furlan, André, Montaser, Alaa S., Jamshidi, Ali O., Ghalib, Luma, Chavez, Jesus A., Lehman, Norman L., Prevedello, Daniel M.
Format: Article
Language:English
Subjects:
Adenoma - diagnosis
Adenoma - surgery
Brain cancer
endocrinology
Humans
Male
Middle Aged
Neoplasms, Radiation-Induced
neurosurgery
pituitary carcinoma
Pituitary Diseases
Pituitary gland
Pituitary Neoplasms - diagnostic imaging
Pituitary Neoplasms - surgery
prolactinoma
Radiation therapy
Surgery
Tumors
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Summary:Introduction: Pituitary carcinomas are poorly understood, rare entities. They are distinguished from adenomas not by histopathological features but rather by the presence of metastases. Objective: We discuss the diagnosis, mechanism of dissemination and pathogenesis based on a review of the literature and illustrated by a singular case. Case Report: A 59-year-old male presented with a dural-based posterior fossa lesion. He had been diagnosed with a pituitary chromophobe adenoma 43 years earlier that was treated at the time with surgery and radiation therapy. A presumptive diagnosis of a radiation-induced meningioma was made and surgery was recommended. At surgery the tumour resembled a pituitary adenoma. Histopathology, laboratory findings, and the patient's medical history confirmed the final diagnosis of a prolactin-secreting pituitary carcinoma. To our knowledge, this is the longest reported interval between the pituitary adenoma and metastatic lesion diagnosis (43 years). Conclusion: Management should be tailored to individual patient and may include a combination of treatments (surgery, radiation therapy, chemotherapy, and hormone-targeted therapy). Functionally active tumours may be monitored with hormone levels as tumour markers.
ISSN:0268-8697
1360-046X
DOI:10.1080/02688697.2019.1582750