Diagnostic and prognostic biomarkers of a sellar melanocytic tumor mimicking pituitary adenoma: Case report and literature review

Primary sellar melanocytoma

“…Histopathological examination of the published cases revealed variable expression of melanocyte-related factors such as S100, HMB-45 and Melan A. (Table 2) Brito et al [25] were not able to identify any of the melanocyte-associated markers. Lach et al [29] described an amelanotic melanocytoma needing electron microscopy to confirm the melanocyte derived origin of the lesion.…”

“…Lach et al [29] described an amelanotic melanocytoma needing electron microscopy to confirm the melanocyte derived origin of the lesion. Three authors described features compatible with a more aggressive form of a melanocyte-derived tumor, including the presence of macroscopic necrosis [27], and a high KI-67 labelling index [25,30]. Nevertheless, Mohammed et al found only few mitoses and reported a pre-operative follow-up of 11 months with only slight growth on sequential MRIs [25].…”

“…All patients received a transsphenoidal resection as firstline treatment. (Table 3) Complete resection was achieved only in a minority of cases (3 out of 14 patients) [25,30,31]. Only Zhou et al converted to a transfrontal craniotomy as the transsphenoidal approach failed due to poor bleeding control, resulting in a macroscopically complete tumor resection [26].…”

“…Patients with metastasis at diagnosis or a primary melanoma elsewhere were excluded. Finally, 23 case reports of pituitary melanocytic tumors were identified [3,6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Because the literature review focused on pituitary melanocytoma, 2 case reports were excluded as they did not contain sufficient information to further differentiate the described melanocytic tumor [13,14], as well as 7 other case reports [3,[15][16][17][18][19][20] reporting on lesions that were clearly melanoma according to the 2016 WHO Classification of Tumors of the Central Nervous System [23].…”

Analysis of Ki67, HMGA1, MDM2, and RB expression in nonfunctioning pituitary adenomas

“…The main therapeutic option for NFPA is surgical and there are currently no pharmacologic treatments available. A variety of histological biomarkers for NFPA have been investigated for their relationship to invasiveness and tumor recurrence, including the proliferation marker Ki-67, cellcycle-related factors such as p27 and galectin-3, and other molecules such as p53,O-6-methylguanine-DNA methyltransferase, and matrix metalloproteinase 9 [5–7]. However, given the absence of reliable serum markers for detecting residual tumor cells, the decision on whether to recommend additional intervention is typically made based on postoperative imaging.…”