Ectopic pituitary adenomas: clinical features, diagnostic challenges and management

Zhu, Jianyu; Wang, Zhicheng; Zhang, Yi; Li, Xiaoxu; Liu, Jie; Deng, Kan; Lü, Lin; Pan, Hui; Wang, Renzhi; Yao, Yong; Zhu, Huijuan

doi:10.1007/s11102-020-01071-x

Cited by 19 publications

(60 citation statements)

References 135 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%

“…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 ). 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 ).…”

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%

“…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. 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 ).…”

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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Clival ectopic pituitary prolactinoma was successfully managed by transsphenoidal surgery: A rare case report

Mansour,

Khozamah,

Naksho

et al. 2023

Clinical Case Reports

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Key Clinical MessageEctopic pituitary adenoma is a rare neoplasm located in the clivus and could mimic other clival tumors. Diagnosis and treatment could be challenging. It should be considered in the differential diagnosis of clival tumors.AbstractEctopic pituitary adenomas (EPAs) are isolated adenomas that can be located in variable locations outside the sella turcica and have a normal‐appearing pituitary gland. These tumors are rare and are thought to often arise from embryological remnants along the route of Rathke's pouch migration. EPAs are associated with a wide range of clinical manifestations depending on hormonal activity and involvement of adjacent structures, which can represent a challenge in making the diagnosis and deciding on the most appropriate management. In this case study, we report a 47‐year‐old male who presented with visual disturbances, a headache, and generalized weakness. Magnetic resonance imaging showed a 2 cm mass located in the clivus invading the sphenoid sinus with an intact pituitary gland. The patient underwent endoscopic transsphenoidal surgery to eradicate the mass while maintaining the integrity of the pituitary gland, which was successful and uneventful. Pathological studies were consistent with prolactinoma, with no cytological malignant features. Post‐surgery, symptoms notably improved, and serum prolactin levels significantly dropped, The patient's condition was satisfactory on follow‐up with no long‐term complications reported. This paper contributes to the existing literature by sharing the clinical management of a challenging and uncommon case.

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World premiere: transoral robot-assisted excision for nasopharyngeal ectopic pituitary adenoma

Louerat,

Hans,

Laroche

et al. 2024

Eur Arch Otorhinolaryngol

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Ectopic pituitary adenomas: clinical features, diagnostic challenges and management

Cited by 19 publications

References 135 publications

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

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

Clival ectopic pituitary prolactinoma was successfully managed by transsphenoidal surgery: A rare case report

World premiere: transoral robot-assisted excision for nasopharyngeal ectopic pituitary adenoma

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