Malignant Lymphoma in the Parasellar Region

Koiso, Takao; Akutsu, Hidenori; Takano, Shingo; Yamamoto, Tetsuya; Ishikawa, Eiichi; Okoshi, Yasushi; Matsumura, Akira

doi:10.1155/2014/747280

Cited by 14 publications

(15 citation statements)

References 30 publications

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“…PPL has a much poorer prognosis when compared to the pituitary involvement of systemic lymphoma ( 6 ). The overall mean survival rate of immunocompetent PPL patients was 14.4 months.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical presentations are always atypical, including headache, hypopituitarism, diplopia, hemianopia, and fever ( 5 ). The PPL prognosis is usually poor, which emphasizes the importance of earlier detection and management to improve the outcomes ( 6 ). Here, we have reported two recently diagnosed cases of PPL with a comprehensive review of our current understanding of PPL.…”

Section: Introductionmentioning

confidence: 99%

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Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature

et al. 2021

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Primary pituitary lymphoma (PPL) represents an extremely rare entity. Here, we have reported two recently identified cases of immunocompetent PPL having diffuse large B-cell lymphoma by surgical biopsy. Both patients had hypopituitarism, with one patient developing right ptosis. In both patients, MRI and FDG-PET/CT depicted sellar mass that extended into the cavernous sinus with the right sphenoid also present in one of the patients. No systemic disease was found in these two patients. Surprisingly, we found that both patients had infiltrative lesions in sphenoid sinus mucosa pathologically, but the sphenoid bones that composed the sellar base were visually intact during the biopsy procedure. Chemotherapy was administered to both patients, where one patient achieved remission at the recent follow-up, whereas the other one did not respond to the treatment. The diagnosis of PPL is usually difficult if solely dependent on history, clinical presentation, biochemical indexes, and radiographic findings. We have also updated and reviewed the epidemiologic features, clinical presentations, pathological characteristics, potential mechanisms, therapeutic orientation, and prognostic advances of PPL. A total of 40 cases (including ours and four pediatric patients), histologically diagnosed, were analyzed in terms of clinical presentation, endocrine abnormality, radiological features, pathology, treatment, and follow-up. Hypopituitarism and headache were the most common presentation of PPL, while diabetes insipidus was reported in 13 patients (43.3%). B cell lymphoma was the most common type of pathology, followed by T-cell and NK/T cell. PPL was more invasive in nature at the suprasellar region (72.5%), cavernous sinus (52.5%), and sphenoidal sinus (27.5%) in 29, 21, and 11 patients, respectively. Pediatric patients with PPL seem to be different compared to their adult counterparts in terms of pathogenesis, clinical presentation, and radiological features. The management of PPL usually follows the treatment protocols for PCNSL but has a poor prognosis compared to the pituitary involvement of systemic lymphoma.

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“…PPL has a much poorer prognosis when compared to the pituitary involvement of systemic lymphoma ( 6 ). The overall mean survival rate of immunocompetent PPL patients was 14.4 months.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature

et al. 2021

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“… 11 While pituitary adenomas are mostly benign, 1 and their effects limited to the over- and undersecretion of pituitary hormones as well as the mass effect on surrounding structures, primary pituitary lymphomas have a much poorer prognosis and hence early detection and management is key to improved outcomes. 12 Although the diagnosis of pituitary lymphoma is mostly dependent on histology, immunohistochemistry and in situ hybridization, suspicion should be raised in a fast-growing tumor presenting with symptoms of apoplexy.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Primary CNS Lymphoma and FSH-Pituitary Adenoma Arising Within the Sella. Entirely Coincidental?

et al. 2017

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BACKGROUND AND IMPORTANCE: Collision tumors are the simultaneous occurrence of more than one type of neoplasm within an anatomic space. In the pituitary sella, collision tumors are exceedingly rare, and not much is known about their etiology and prognosis. CLINICAL PRESENTATION: A 74-year-old man presented with a concomitant primary pituitary lymphoma (diffuse large B-cell non-Hodgkin's lymphoma; DLBCL) and follicle-stimulating hormone (FSH)-adenoma diagnosed histologically after clinical features of apoplexy prompted urgent surgical decompression and resection. Strong immunoreactivity for FSH by the lymphoma was evident. Full-body workup demonstrated no other source for the lymphoma. He subsequently underwent 4 cycles of chemotherapy and has been in remission for over 32 months. His ophthalmoplegia at presentation persisted with no further deficits. CONCLUSIONS: Four cases of collision tumors of primary pituitary lymphoma and adenoma have previously been reported. This case represents the first combination of an FSH-adenoma and a DLBCL in the literature. Prompt involvement of the hematology-oncology team contributed to the good outcome seen in this case. The putative role played by pituitary hormones in tumorigenesis is reviewed in this case report. The association is either a chance occurrence or due to the induction of lymphoma cell proliferation by the binding of FSH produced by the adenoma to the FSH receptors on the lymphoma cells.

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“…Histologically, B-cell non-Hodgkin lymphomas represent the majority of pituitary lymphomas. Chemotherapy is the treatment option [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Hypophyseal metastases: A report of three cases and literature review

Ravnik

Ŝmigoc

Bunc

et al. 2016

Neurologia i Neurochirurgia Polska

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Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis. A transnasal endoscopic biopsy and resection of the tumour was performed in all patients, followed by the oncological treatment. Despite the rarity of the disease, it is important to suspect a metastatic pituitary tumour especially in the case of diabetes insipidus, ophthalmoplegia, rapid course of the disease and headaches. In 20-30% of patients, a metastasis to the pituitary is the first manifestation of a tumour of unknown origin. Surgical and adjuvant therapy may improve the quality of life. The survival is not affected, however, and the prognosis of the disease is usually poor.

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Malignant Lymphoma in the Parasellar Region

Cited by 14 publications

References 30 publications

Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature

Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature

Concomitant Primary CNS Lymphoma and FSH-Pituitary Adenoma Arising Within the Sella. Entirely Coincidental?

Hypophyseal metastases: A report of three cases and literature review

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