Ectopic Pituitary Adenoma: Case Report with Review of Literature

Abstract

Ectopic pituitary adenoma (EPA) is a rare presentation first described by Erdheim. Most of the EPAs described in literature occur in the sphenoid sinus or suprasellar region. We describe a case of an EPA originating from the choana presenting as a case of nasal mass along with detailed literature review.

Null-Cell Ectopic Pituitary Adenoma of the Nasal Cavity

“…During approximately the eighth week of gestation, a portion of this structure detaches and migrates via the craniopharyngeal canal into the sellar, ultimately forming the anterior section of the pituitary gland, the site from which the majority of pituitary adenomas originate. It is worth noting that ectopically deposited cells have the infrequent potential to give rise to adenomas at various locations along this migratory pathway [ 1 , 9 , 10 ]. Since its first description by Erdheim in 1909, several ectopic sites have been reported, namely, sphenoid sinus, clivus, parapharyngeal space, nasal cavity, nasopharynx, third ventricle, and suprasellar region [ 2 , 4 , 11 ].…”

“…Imaging investigations will not only show a normal pituitary gland and sellar turcica but will also show the size of the tumor, provide details on its margins, and extent and help with surgical planning [ 9 , 11 ]. Traditionally, MRI shows mild to moderate heterogenous contrast enhancement, without a unique T1- or T2-weighted image intensity, whereas nonenhanced CT demonstrates tumors that are iso to hypodense to grey matter, showing modest enhancement in postcontrast studies [ 1 , 9 ]. Our case served as a demonstration of both of these findings.…”

“…As such, a number of parameters, including clinical symptoms, tumor size, location, degree of invasion, and hormone-secreting type, should be taken into consideration when treating them [ 3 ]. Surgical excision is generally considered the cornerstone of treatment, with radiotherapy reserved for cases of incomplete resection [ 1 , 9 ]. Several novel case studies have also cited success with pharmacological treatment in hormonally active EPA cases [ 9 , 12 ].…”

“…Pituitary adenomas are benign tumors that arise from the pituitary gland and account for approximately 10–15% of all intracranial neoplasms [ 1 ]. They are commonly classified based on their size, hormone secreting capacity, and location within the gland.…”