Ectopic macroprolactinoma mimicking a chordoma: a case report.

Ballaux, D.; Verhelst, Johan; Pickut, B.A.; Deyn, Peter Paul De; Mahler, C.

doi:10.1677/erc.0.0060117

Cited by 19 publications

(10 citation statements)

References 36 publications

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“…[16111416] Most of the EPAs are situated outside the blood–brain barrier and approximately 40% are located in the sphenoid sinus (SS). [121417] We present a case of EPA within the SS associated with empty sella which was confirmed with the surgical proof of an intact dura of the sellar floor.…”

Section: Introductionmentioning

confidence: 53%

“…Intracranial EPAs are found in the hypothalamic region, cavernous sinus, third ventricle, pituitary stalk, and suprasellar region, while extracranial ones are usually located at the SS or the sphenoid bone, and rarely at the nasopharynx or clivus. [121114171922]…”

Section: Discussionmentioning

confidence: 99%

“…[26814] Extracranial EPAs may arise from orthotopic pharyngeal pituitary tissue in the nasopharyngeal region which then can reach the SS through its opening, or it may originate from remnant pituitary tissue in the craniopharyngeal canal which might be retained during the cephalic invagination of Rathke's pouch. [246–81011141620–22] Intracranial extrasellar adenomas, also known as intracranial ectopy, arise from cell remnants of the sellar pituitary gland, which were likely retained during development. [14] EPAs are classified into three types: type 1 EPAs develop from remnant pituitary cells along Rathke's pouch migration pathway, type 2 are derived from cells of the supradiaphragmatic portion of the pars tuberalis located in the suprasellar region; and type 3 are actually invasive pituitary adenomas.…”

Section: Discussionmentioning

confidence: 99%

“…[21518] Although almost all of them arise within the sella turcica, there are some rare cases in which a pituitary adenoma is located outside the intrasellar region, and if there is an empty sella too, it is an even more rare finding. If this is placed outside the sella and it is not in continuity with an intrasellar normal pituitary gland or an empty sella, it is defined as an ectopic pituitary adenoma (EPA), which may be intra or extracranial.…”

Section: Introductionmentioning

confidence: 99%

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Ectopic prolactinoma within the sphenoidal sinus associated with empty sella

Ajler

Bendersky²,

Hem³

et al. 2012

Surg Neurol Int

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Background:Pituitary adenomas are a common cause of endocrinal dysfunction, which comprise 10–20% of all intracranial tumors. Although almost all of them arise within the sella turcica, there are some rare cases in which a pituitary adenoma is located outside the intrasellar region, so it is defined as an ectopic pituitary adenoma (EPA).Case Description:We described a case of a 31-year-old male with a serum prolactin (PRL) value of 240 ng/ml Magnetic resonance imaging (MRI) showed a space-occupying mass within the sphenoid sinus (SS) which partially enhanced by gadolinium. MRI did not reveal any sellar floor defect and an empty sella was detected. As dopamine agonist treatment had failed in lowering the serum PRL level, he underwent surgical treatment. A transsphenoidal approach without opening the sellar floor was performed using an operating microscope and the lesion within the SS was completely removed.Conclusion:Although intrasphenoidal EPAs are rare findings, the presence of an endocrine disorder related to pituitary hormones, and a space-occupying mass within the SS associated with either a normal sellar pituitary gland or an empty sella must lead us to suspect this diagnosis.

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Section: Introductionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ectopic prolactinoma within the sphenoidal sinus associated with empty sella

Ajler

Bendersky²,

Hem³

et al. 2012

Surg Neurol Int

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“…Other extracranial sites include the nasal cavity, mid-nasal ductus, nasopharynx (3,28,29), clivus (30)(31)(32)(33)(34)(35), sphenoid, ethmoid, petrous and temporal bone. The majority of the intracranial extrasellar EPAs are located in the suprasellar region (approximately 33%), usually contiguous with the pituitary stalk (28,36).…”

Section: Discussionmentioning

confidence: 99%

Ectopic Pituitary Adenome of the Sphenoid Sinus. Case Report

Tătăranu¹

2013

Acta Endo (Buc)

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Introduction. Ectopic sphenoid sinus pituitary adenomas are a rare, benign pituitary tissue neoplasm, occurring separate from and without involvement of the anterior pituitary gland. We present a case of ectopic pituitary adenoma confined to the sphenoid sinus, asociated with an empty sella.Case report. A 52-year-old man was addmitted to our neurosurgical department with persistent headache and nasal obstruction of one year duration. Patient presented no endocrine abnormalities and no visual disturbances. MRI revealed a well-defined mass lesion in the sphenoid sinus, hypointense on T 1 -weighted images, hyperintense on T 2 -weighted images, with moderate heterogeneous gadoliniumenhancement. A primary empty sella was associated. Surgery was performed by transnasal transsphenoidal approach. The tumor was removed in a piecemeal fashion. The bony sellar floor was intraoperatively proven to be intact. The pathologic studies confirmed the diagnosis of ectopic nonfunctional pituitary adenoma of the sphenoid sinus. The postoperative course was uneventful.Conclusions. When encountering a tumor within the sphenoid sinus, an ectopic pituitary adenoma should be suspected.A clinical, imaging and endocrinologic evaluation must be undertaken, aiming to identify the nature of the lesion and to initiate the specific therapy. Surgery remains the only way of obtaining a definite diagnosis and cure.

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