Ectopic GH-secreting pituitary adenoma of the clivus: systematic literature review of a challenging tumour

Riccio, Lucia; Donofrio, Carmine Antonio; Tomacelli, G.; Blasi, Roberto De; Melatini, Alessandro

doi:10.1007/s11102-020-01057-9

Cited by 7 publications

(8 citation statements)

References 49 publications

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“…During this process, embryological cells of the adenohypophysis migrate through the craniopharyngeal canal to the nasopharynx or sphenoid sinus before uniting with the neurohypophysis in the sella turcica of the sphenoid bone. Infrasellar EPAs can thus be a result of persisting embryological cells along the migration pathway, manifesting in the sphenoid sinus or nasopharynx ( 1 , 2 ). Alternatively, suprasellar EPAs may be derived from cells of the supradiaphragmatic portion of the pars tuberalis in the suprasellar region ( 1 , 9 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, suprasellar EPAs may be derived from cells of the supradiaphragmatic portion of the pars tuberalis in the suprasellar region ( 1 , 9 , 13 ). Another potential explanation is aberrant embryological cells migrating through the craniopharyngeal canal to both extracranial (infrasellar—nasopharynx, sphenoid sinus, clivus) and intracranial (supra- and parasellar) areas ( 2 , 13 ). The most common location for EPAs is the suprasellar and sphenoid sinus followed by the nasopharynx.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Pituitary adenomas originate from the adenohypophysis, and ectopic pituitary adenomas (EPAs) are extrasellar and are separate from the hypophysis and infundibulum ( 1 , 2 ). EPA pathogenesis largely relates to the embryological development and migration of the adenohypophysis ( 1 , 2 ). EPAs are rare with approximately 180 cases described according to a recent extensive literature review ( 1 ), and clinical manifestations vary widely, depending on their secretory profile, size, and anatomical location.…”

Section: Introductionmentioning

confidence: 99%

“…EPAs are rare with approximately 180 cases described according to a recent extensive literature review ( 1 ), and clinical manifestations vary widely, depending on their secretory profile, size, and anatomical location. Symptoms often mimic those of the skull base or nasopharyngeal tumors and occur due to mass effect on adjacent structures, resulting in visual disturbance, facial paraesthesia, headache, and nasal congestion ( 2 , 3 ). Specifically, nasopharyngeal and sphenoid sinus EPAs commonly present with epistaxis and nasal congestion, while sphenoid bone EPAs can also present with headache and cranial neuropathy ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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A patient with an ectopic sphenoid bone TSH secretory adenoma: Case report and review of the literature

Kumar

Phang

et al. 2022

Front. Endocrinol.

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Ectopic thyroid-stimulating hormone (TSH)oma located outside the sella turcica is exceedingly rare and can be associated with significant diagnostic delay. The clinical presentation depends on the anatomical location and size of the ectopic tumor and the degree of thyrotoxicosis. A 71-year-old woman presented with goiter and thyrotoxicosis. Initial investigations revealed elevated free thyroxine (fT4) and tri-iodothyronine (fT3) with inappropriately high-normal TSH. Assay interference was unlikely, pituitary magnetic resonance imaging (MRI) scan was reported as “normal,” and germline sequencing was negative for thyroid hormone receptor ß pathogenic variants. One year later, total thyroidectomy for enlarging symptomatic goiter and suspicious nodule revealed multifocal microscopic papillary thyroid carcinoma. Six years later, she presented to an ear, nose, and throat surgeon with nasal congestion, and a sphenoid bone mass was discovered on nasoendoscopy and imaging. Ectopic TSHoma was confirmed on surgical resection, and a review of the initial pituitary MRI scan revealed the mass which had initially been missed. This is the first reported case of an ectopic TSHoma located in the sphenoid bone. Ectopic TSHoma should be considered in patients with inappropriate TSH secretion when more common differentials are excluded including thyroid hormone resistance or pituitary TSHoma.

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