Anterior Pituitary Component in Benign Cystic Ovarian Teratomas: Report of Three Cases

Akhtar, Mohammed; Young, Irving; Brody, Henry

doi:10.1093/ajcp/64.1.14

Cited by 18 publications

(3 citation statements)

References 4 publications

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“…Hyperprolactinaemia from uterine dermoid tumors has been reported by others previously [ 26 ]. Dermoid tumors can differentiate into other types of cells acquiring their secretory components, thus making them a potential source of ectopic hyperprolactinaemia [ 29 , 30 ]. In the limited previous reports of ectopic extracranial prolactin secretion in the published literature, ovarian germ cell tumors associated with hyperprolactinaemia had microscopic pituitary elements [ 25 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

Ectopic hyperprolactinaemia due to a malignant uterine tumor resembling ovarian sex cord tumors (UTROCST)

et al. 2020

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Purpose Moderate hyperprolactinaemia (2–5 times upper limit of normal) occurring in a patient with a normal pituitary MRI is generally considered to be due to a lesion below the level of detection of the MRI scanner assuming macroprolactin and stress have been excluded. Most patients with mild-to-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We present the rare case of a patient who had prolactin elevation typical of a prolactin-secreting pituitary macroadenoma,with a normal cranial MRI, and in whom the prolactin rose further with dopamine agonist treatment. Subsequent investigations revealed ectopic hyperprolactinaemia to a uterine tumor resembling ovarian sex cord tumor (UTROSCT) which resolved following tumor resection. Although mostly considered to be benign, the UTROSCT recurred with recurrent hyperprolactinaemia and intraabdominal metastases. Methods We have systematically and critically reviewed existing literature relating to ectopic hyperprolactinaemia in general and UTROCST specifically. Results Fewer than 80 cases of UTROSCTs have been reported globally of which about 23% have shown malignant behaviour. There are fewer than 10 cases of paraneoplastic hyperprolactinaemia originating from uterine neoplasms including one other case of ectopic hyperprolactinaemia to a UTROSCT. Conclusions Our case demonstrates the importance of screening for extracranial hyperprolactinaemia in the context of: (1) substantially raised prolactin (10× ULN) and (2) normal cranial MRI assuming macroprolactin has been excluded. The majority of extracranial ectopic prolactin-secreting tumors occur in the reproductive organs.

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Section: Discussionmentioning

confidence: 99%

Ectopic hyperprolactinaemia due to a malignant uterine tumor resembling ovarian sex cord tumors (UTROCST)

et al. 2020

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“…Benign cystic teratoma is one of the commonest human germ cell tumours and is often found in the ovary in women of reproductive age 1 . The great diversity in site of occurrence and clinical presentation of teratomas in general occasionally leads to diagnostic difficulty, while the range of unusual to bizarre associated findings has resulted in several reports of novelty value in the world literature 2–9 .…”

Section: Discussionmentioning

confidence: 99%

Mobile globules in benign cystic teratoma of the ovary

Otigbah

Thompson

Lowe

et al. 2000

BJOG

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Case reportA 39 year old nulliparous woman was referred to the outpatient department by her general practitioner following the detection of an abdominal swelling, found incidentally during a routine visit to obtain a cervical smear for cytology. She had no other medical complaints and had not noted any pressure symptoms or systemic disturbance in association with the mass. The previous cervical smears had been normal.She had regular menstrual periods, bleeding for five days in a 28 day cycle. There had been no associated bleeding irregularity, pain or significant weight loss. She was not sexually active and therefore did not use any contraceptives, although she had had an intrauterine contraceptive device inserted for one year, 12 years previously.This was removed following an episode of severe pelvic pain. A left ovarian cyst had also been diagnosed 18 years prior to this referral. The cyst appeared to have resolved spontaneously and no further treatment had been required. She smoked about 20 cigarettes per day and suffered from mild chronic bronchitis. In addition, she was receiving treatment for left lower limb sciatica.General physical findings were normal at presentation. There was no sign of pallor, lymphadenopathy, respiratory or cardiovascular disease. Further examination revealed a nontender, smooth, cystic mass arising from the pelvis which was consistent in size with an 18-week pregnancy. There was no other palpably enlarged organ, no clinical evidence of ascites, and no bruit were heard over the mass. Pelvic examination revealed a mobile, normal sized uterus, separate from, and anterior to the mass.Laboratory investigations performed subsequently were all reported normal. These included estimation of the serum CA125, alpha fetoprotein, carcinoembryonic antigen, human chorionic gonadotrophin and serum carbohydrate antigen C19-9. A full blood count, kidney

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“…The presence of any other endocrine tissues in mature cystic teratomas is extremely uncommon. Rare cases of pituitary tissue within benign cystic teratomas have been reported (2), some including adenohypophyseal and neurohypophyseal elements (3), whereas others were functioning pituitary corticotroph and prolactin-producing adenomas (4Y6). To our knowledge, there have been no reports of pituitary tissue in struma ovarii.…”

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confidence: 99%

Silent Corticotroph Cell Pituitary Adenoma in a Struma Ovarii

Waugh

Soler

Robboy

2007

International Journal of Gynecological Pathology

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This is the first report of a silent corticotroph cell pituitary adenoma arising in a struma ovarii. The patient, a 79-year-old woman, was found to have an asymptomatic left-sided adnexal mass confirmed by vaginal sonography to be a complex cystic and solid tumor. Pathological analysis demonstrated an 8-cm partially cystic struma ovarii in which there was a focus of predominantly basophilic adenohypophyseal cells arranged in a diffuse pattern, adjacent to mature neural tissue containing numerous Herring bodies. The epithelial lining cells of the colloid-filled small and cystic follicles were immunoreactive for thyroglobulin. The pituitary cells were predominantly immunoreactive for adrenocorticotropic hormone, in addition to synaptophysin.

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Anterior Pituitary Component in Benign Cystic Ovarian Teratomas: Report of Three Cases

Cited by 18 publications

References 4 publications

Ectopic hyperprolactinaemia due to a malignant uterine tumor resembling ovarian sex cord tumors (UTROCST)

Ectopic hyperprolactinaemia due to a malignant uterine tumor resembling ovarian sex cord tumors (UTROCST)

Mobile globules in benign cystic teratoma of the ovary

Silent Corticotroph Cell Pituitary Adenoma in a Struma Ovarii

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