CSF Dissemination of a Pituitary Adenoma : A Case Report

Tanaka, Yoshihide; Tsuda, Masako; Sato, Masazumi; Kanno, Hiroshi; Tokoro, Kazuhiko; Yamamoto, Isao; Kimura, Seiko; Kitamura, Hitoshi

doi:10.7887/jcns.5.391

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…In the second, the primary tumor shows originally benign histology but malignant transformation is recognized at metastasis. 6,17) In the third, the histology remains benign even if metastasis occurs. Our case corresponds to the third form, of which there have been four previous cases.…”

Section: Discussionmentioning

confidence: 99%

Long-term Survival With Non-functioning Pituitary Carcinoma -Case Report-

Koyama

Ikeda

Shose

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 35-year-old woman presented with a non-functioning pituitary adenoma manifesting as amenorrhea and impaired visual acuity in 1984. The tumor was grossly totally resected through a right frontotemporal craniotomy. The patient underwent surgery for three recurrences in the next 5 years. She was treated with gamma knife surgery for the residual tumor in 1994. Follow-up magnetic resonance (MR) imaging revealed a tumor in the right frontal base in 1999, and the left middle fossa in 2002. Total removal of these tumors was performed. Follow-up MR imaging showed regrowth of the primary pituitary tumor in 2003, which was partially excised. Histological examination of the specimens from the last three surgeries revealed typical pituitary adenoma without malignant transformation. Pituitary carcinomas have a poor prognosis. However, the present patient survived for 22 years from onset and 6 years from the first dural metastasis. Distant lesions should be removed for histological evaluation to assist the subsequent management.

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Section: Discussionmentioning

confidence: 99%

Long-term Survival With Non-functioning Pituitary Carcinoma -Case Report-

Koyama

Ikeda

Shose

et al. 2007

Neurol. Med. Chir.(Tokyo)

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“…Notably, Tanaka et al reported a 70% incidence of metastasis following surgery among 30 cases of primary PitNETs ( 10 ). Other modes of metastasis such as hematogenous spread were not considered in our case, because the patient’s Ki-67 index, at a mere 2%, and the negative P53 status collectively suggest a low proliferative rate and a diminished metastatic propensity.…”

Section: Discussionmentioning

confidence: 99%

Intracranial seeding of pituitary neuroendocrine tumor: a case report

Deng,

Gu,

Sun

et al. 2024

Gland Surg

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Background Pituitary neuroendocrine tumors (PitNETs) are predominantly benign, though a minority may exhibit invasive tendencies. A diagnosis of metastatic PitNETs, in the absence of malignant histology, hinges on the identification of craniospinal and/or systemic metastases. Only a minority of PitNETs exhibit intracranial seeding. Notably, craniotomy for PitNETs excision is a prominent catalyst for iatrogenic seeding. Case Description This article presented a compelling case that 15 years following craniotomy for the resection of a somatotroph PitNET, a lesion emerged at the left frontal base within the ethmoid sinus. Subsequent post-operative pathology unveiled a mature plurihormonal pituitary specific transcription factor 1 (PIT-1)-lineage PitNET. Growth hormone (GH) levels decreased significantly from 22.8 ng/mL pre-operation to 2 ng/mL post-operative, and concurrently, prolactin (PRL) levels decreased from 26.7 ng/mL pre-operation to 4.5 ng/mL post-operation. Furthermore, in the follow-up examination conducted 5 months after the operation, both GH and PRL levels were found to be within the normal range for the patient. This robustly suggested that the initial surgical procedure played a key role in the development of the lesion. Conclusions This underscores the paramount significance of strictly adhering to the non-tumor removal during craniotomy for PitNETs excision. Regardless of apparent complete resection on imaging, it remains imperative to conduct routine follow-up evaluations, encompassing both imaging studies and hormone level assessments.

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“…According to the existing literature, the metastases of pituitary tumors mostly occur after surgery, in particular after craniotomy. As reported by Tanaka et al ., the development of metastases followed surgery performed for primary pituitary tumors in 21 (70%) of 30 cases [ 21 ]. Therefore, it was suggested that surgery may precipitate postoperative metastasis of pituitary adenomas.…”

Section: Discussionmentioning

confidence: 99%

Multiple intracranial and spinal metastases from a nonfunctioning pituitary adenoma following multiple surgeries: an illustrative case with 16 years of follow-up

Wang

et al. 2014

World J Surg Onc

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Pituitary adenomas are the third most common primary intracranial tumor; however, those with postoperative metastases are very rare and are classically considered as pituitary carcinomas. The field of neurosurgery has struggled with diagnosing and treating these unusual lesions. In this report, we retrospectively analyze the clinical features, imaging findings, pathological characteristics and prognosis of one patient with non-hormone-secreting pituitary adenoma who had multiple intracranial and spinal metastases and underwent four surgeries in a 16-year follow-up period. In addition, on the basis of the existing literature, we explore the underlying mechanisms of, as well as the preventive and therapeutic strategies used to treat, pituitary carcinomas and postoperative metastasis of pituitary tumors.

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CSF Dissemination of a Pituitary Adenoma : A Case Report

Cited by 4 publications

References 23 publications

Long-term Survival With Non-functioning Pituitary Carcinoma -Case Report-

Long-term Survival With Non-functioning Pituitary Carcinoma -Case Report-

Intracranial seeding of pituitary neuroendocrine tumor: a case report

Multiple intracranial and spinal metastases from a nonfunctioning pituitary adenoma following multiple surgeries: an illustrative case with 16 years of follow-up

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