Ectopic pituitary adenoma in the sphenoid sinus causing acromegaly associated with empty sella

Matsuno, Akira; Katayama, Haruko; Okazaki, Ryo; Toriumi, M; Tanaka, Hideki; Akashi, Masahiro; Tanaka, Koshi; Murakami, Mineko; Nagashima, Tadashi

doi:10.1046/j.1440-1622.2001.02173.x

Cited by 30 publications

(26 citation statements)

References 32 publications

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“…It has been suggested that, during the formation of the anterior pituitary gland, most of the nasopharyngeal precursors (which later give rise to EPAs) remain in the sphenoid bone (which later become the sphenoid sinus). In these patients, only a small number of cells migrated to form the anterior pituitary, thus resulting in the formation of empty sellas [2,10,11]. Esteban et al [12] postulated that the empty sella in their patient was possibly secondary to radiation therapy for Cushing's syndrome.…”

Section: Discussionmentioning

confidence: 99%

Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings

Yang¹,

Chong²,

Wang³

et al. 2010

BJR

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ABSTRACT. Ectopic pituitary adenomas (EPAs) are rare lesions. The purpose of this study was to describe the CT and MRI features of sphenoid sinus EPAs. Eight patients with histology-proven EPAs in the sphenoid sinus, all of whom underwent CT and MRI, were reviewed retrospectively. The following imaging features were analysed: (i) size, (ii) margin, (iii) CT attenuation characteristics and (iv) MRI signal intensity. In addition, the involvement of adjacent structures and the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI were analysed. All EPAs had well-defined margins and showed no relationship to the intrasellar pituitary gland. The mean size was 28 mm (range, 20-46 mm). On non-enhanced CT, the lesions appeared isodense to grey matter in 7 (88%) patients and hypodense in 1 (12%) patient. Only two patients underwent post-contrast CT, and they showed moderate enhancement. On T 1 weighted images, EPAs appeared isointense in 6 (75%) patients and hypointense in 2 (25%). On T 2 weighted images, the lesions appeared hyperintense in 2 (25%) patients and isointense in 6 (75%). EPAs showed mild to moderate heterogeneous contrast enhancement and exhibited a cribriform-like appearance. Two patients underwent DCE MRI; the TIC showed a rapidly enhancing and slow washout pattern. The following features were also seen: an empty sella, bone changes and involvement of the cavernous sinus (5 patients; 62.5%). In conclusion, a high index of suspicion for EPA and a familiarity with the imaging findings may help to diagnose this rare entity accurately.

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Section: Discussionmentioning

confidence: 99%

Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings

Yang¹,

Chong²,

Wang³

et al. 2010

BJR

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“…Initial intrasellar localization of a pituitary adenoma with a following localized or diffuse destruction of sellar floor and extension into the sphenoid sinus -grade 3 and 4 in modified Hardy's system -is expected in 35% and 10% of cases, respectively [13]. Although MRI may help to confirm the integrity of sellar dura and sellar floor [4,10,12,19], the gold standard is an intraoperative verification [2,5,6,[9][10][11]15]. In case of bone erosion of sphenoid, the evidence of ESSPA seems less justifiable.…”

Section: Discussionmentioning

confidence: 99%

Three cases of ectopic sphenoid sinus pituitary adenoma

Bobeff¹,

Wiśniewski²,

Papierz³

et al. 2017

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“…The criteria for diagnosing ectopic adenoma require detailed histopathological examinations including immunocytochemical and ultrastructural studies [2]. Both immunohistochemical demonstration of neuroendocrine markers and pituitary hormones, and ultrastructural studies of tumour cells provide an accurate diagnosis of pituitary adenoma [2].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the fourth case of ectopic pituitary adenoma found in the midline of the nasopharyngeal region [2,4,10].…”

Section: Introductionmentioning

confidence: 96%