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

Abstract

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.

• Authors: Alexandre B Todeschini, André Beer-Furlan, Alaa S Montaser, Ali O Jamshidi, Luma Ghalib, Jesus A Chavez, Norman L Lehman, Daniel M Prevedello
• Journal: British journal of neurosurgery (Br J Neurosurg) Vol. 34 Issue 5 Pg. 528-533 (Oct 2020) ISSN: 1360-046X [Electronic] England
• PMID: 30836020 (Publication Type: Case Reports, Journal Article)

Topics

• Adenoma (diagnosis, surgery)
• Humans
• Male
• Middle Aged
• Neoplasms, Radiation-Induced
• Pituitary Neoplasms (diagnostic imaging, surgery)