Gonadotropic pituitary carcinoma: HER-2/neu expression and gene amplification

Abstract

The authors report on two gonadotropic carcinomas of the adenohypophysis that occurred in a55-year-old man (Case 1) and a 53-year-old woman (Case 2), with signs of mass effect and amenorrhea, respectively. Both lesions were macroadenomas. The tumor in Case 1 metastasized to dura mater, skull, nasal sinus, and larynx 2 years after patient presentation, whereas that in Case 2 spread to vertebral bodies and ribs after a 19-year latency. Histologically, the primary, recurrent, and metastatic lesions in Case 1 featured brisk mitotic activity and high MIB-1 levels as well as p53 labeling indices. Immunoreactivity for HER-2/neu was assessable only in rare neoplastic cells of the second recurrence and in 80% of cells of the dural metastasis. Low-level HER-2/neu gene amplification was evident in the recurrent tumors and metastasis. The sellar and metastatic tumors in Case 2 resembled benign gonadotropic adenoma with oncocytic change; p53 accumulation, HER-2/neu overexpression, and HER-2/neu gene amplification were not present. The results indicate that low-level amplification of the HER-2/neu gene might be associated with pituitary carcinomas in which more aggressive behavior is seen. Further studies are needed to determine whether HER-2/neu plays a role in the pathogenesis of pituitary carcinoma.

Atypical pituitary adenoma with malignant features

“…Despite the benign histology of many of these tumors, life expectancy is usually less than one year from time of diagnosis. Furthermore, several reports have indicated that carcinomas likely arise from progressive malignant transformation of adenomas and associated ultrastructural or genetic alterations [12,13,15,16].…”

Cytopathologic Features of Pituitary Carcinoma with Cervical Vertebral Bone Metastasis

“…1,3 Common distant metastatic sites are liver, cervical lymph nodes, bone and lung. [1][2][3][4][5][6]9,10,17 Only 39 cases of ACTHproducing pituitary carcinomas have been described in the literature to date. 8,10 Thirty-four of them were recently reviewed by Holthause et al, 18 and those authors noted that 16 (45%) cases exhibited extracranial …”

Metastatic prolactinoma: case report with immunohistochemical assessment for p53 and Ki-67 antigens

“…For instance, a myriad of genetic mutations has been re p o rted in such tumors 1 2 , 1 9 -2 1 , but their assessment has shown little, if any, clinical usefulness 1 2 . Besides, several biochemical and histopathological markers have recently been investigated in order to evalu- ate the etiopathology of pituitary carcinomas, but still without conclusive results [22][23][24][25][26][27][28][29][30][31][32] .…”