Cushing-type ectopic pituitary adenoma with unusual pathologic features

Kristopher T. Kimmell, Mahlon Johnson, Rakhil Rubinova, G. Edward Vates

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Ectopic pituitary adenomas comprise, by varying reports, approximately 1-2% of all pituitary adenomas. They are often located in the nasopharyngeal region associated with the pharyngeal pituitary. The location and pathologic features of these masses make them atypical when compared with intrasellar pituitary adenomas. A 54-year-old man presented with vertebral compression fracture and physical stigmata of Cushing's disease. Biochemical testing confirmed hypercortisolemia responsive to high dose dexamethasone suppression. MRI of the head demonstrated an enhancing mass in the posterior aspect of the sphenoid sinus not involving the sella turcica. Endoscopic biopsy followed by resection confirmed this mass to be a pituitary adenoma with unusual pathologic features. Most notably, the tumor cells demonstrated large, eosinophilic, vacuolated cytoplasm. Immunohistochemical profile of the tumor was typical of an ACTH secreting tumor, notably with positivity for ACTH. The patient did well from his surgery. Post-operatively his serum cortisol level normalized and he remains in chemical remission one year after surgery. Ectopic pituitary adenomas are an unusual manifestation of hormonally active pituitary neoplastic disease. Their atypical clinical presentations, location, and pathologic features can make them a diagnostic challenge. Clinicians should be aware of these entities, especially when considering differential diagnosis for a mass in the sphenoid sinus and nasopharyngeal region.

Original languageEnglish (US)
Pages (from-to)31-33
Number of pages3
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume1
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Pituitary Neoplasms
Sphenoid Sinus
Adrenocorticotropic Hormone
Pituitary Diseases
Sella Turcica
Compression Fractures
Christianity
Pituitary ACTH Hypersecretion
Neoplasms
Dexamethasone
Hydrocortisone
Cytoplasm
Differential Diagnosis
Head
Biopsy
Serum

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Cushing-type ectopic pituitary adenoma with unusual pathologic features. / Kimmell, Kristopher T.; Johnson, Mahlon; Rubinova, Rakhil; Vates, G. Edward.

In: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management, Vol. 1, No. 2, 01.01.2014, p. 31-33.

Research output: Contribution to journalArticle

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