Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report

Sironi, Maria; Cenacchi, Giovanna; Cozzi, Luca; Tonnarelli, G; Iacobellis, Michela; Trerè, D; Assi, Ali A.

doi:10.1136/jcp.55.2.148

Cited by 27 publications

(11 citation statements)

References 24 publications

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“…In some cases, metastases only manifested during autopsy (14,18,20,21). Intracranial metastases were reported in the frontal lobe (7,9,12,18,19,22,23,27,33,34), parietaloccipital lobe (6,22,29), temporal lobe (10,18,24,28,33), cerebellum (4,8,12,14,29,38), cerebellopontine angle (5,18,31), brainstem (17,20,28,38), and subarachnoid space (9,14,20). Less commonly involved areas were the cranial nerves (20,27) and the orbital space (15,18,28,35).…”

Section: Discussionmentioning

confidence: 99%

Malignant prolactinoma: case report and review of the literature

Kars

Roelfsema²,

Romijn³

et al. 2006

eur j endocrinol

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Pituitary carcinomas are extremely rare. In general, the initial clinical, biochemical, and histological characteristics are of minimal utility in distinguishing benign adenomas from pituitary carcinomas. We describe a 63-year-old woman with a macroprolactinoma, who presented with diplopia and blurred vision. This unusual initial presentation and the subsequent aggressive clinical course, with diffuse local and distant intramedulary metastases, prompted us in retrospect to make a detailed analysis of the therapeutic interventions and histology. In addition, we reviewed all available literature on published cases of malignant prolactinoma and detailed their epidemiological, clinical, and histopathological characteristics. In brief, it is postulated that pituitary carcinomas arise from the transformation of initially large, but benign, adenomas. Unusual and/or atypical clinical manifestations appear to occur more frequently. In vivo, the development of dopamine agonist resistance in invasive macroprolactinoma is indicative of malignancy and should prompt the clinician to perform a biopsy of the tumor. For pituitary tumors that exhibit high mitotic activity, increased Ki-67 and/or p53 immunoreactivity, it may be useful to denote these tumors as 'atypical' prolactinomas to raise the possibility of future malignant development.European Journal of Endocrinology 155 523-534

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Section: Discussionmentioning

confidence: 99%

Malignant prolactinoma: case report and review of the literature

Kars

Roelfsema²,

Romijn³

et al. 2006

eur j endocrinol

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“…No metastasis was detected by whole-body screening and the diagnostic criteria were not satisfied, but the growth potential corresponded to that of pituitary carcinoma. Pituitary carcinomas probably arise from progressive malignant transformation of adenomas and associated ultrastructural or genetic alterations [16,17], so some aggressive tumors might have overt malignant feature and yet not fulfill the strict criteria for carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Somatostatin-Producing Atypical Null Cell Adenoma Manifesting as Severe Hypopituitarism and Rapid Deterioration—Case Report

2010

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Atypical adenoma has an aggressive biological character, invades the surrounding structures, and grows rapidly. Morphological malignant findings such as increasing cellularity and nuclear atypism are not involved in this entity, but some cases with overt malignant features such as significant nuclear atypism and/or necrosis are known. Null cell adenoma generally grows slowly, but hormone secretion is little understood. Atypical null cell adenoma is rare, and hormone production is unknown. A 55-year-old woman presented with severe hypopituitarism and diabetes insipidus and bilateral upper temporal quadrantanopsia. Head magnetic resonance imaging revealed a large sellar tumor compressing the optic chiasm. Transsphenoidal surgery was performed, but the tumor was partially removed because of invasion into the neuronal structures. Histological examination showed atypical null cell adenoma with significant nuclear atypism and extensive necrosis. Immunohistochemistry showed positive reaction to somatostatin. Adjuvant treatment was planned, but the tumor regrew within 3 months. Conventional irradiation resulted in slight decrease in tumor size, but she required assistance for every type of daily activity. Atypical null cell adenoma has an aggressive biological character, and immediate adjuvant treatment is essential. Somatostatin secretion was proven in this tumor type.

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“…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].…”

Section: Discussionmentioning

confidence: 99%

Atypical pituitary adenoma with malignant features

et al. 2008

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Pituitary carcinoma is characterized by the presence of systemic or central nervous system metastases rather than malignant histological features, making it an anomaly amongst carcinomas. In contrast, aggressive or atypical pituitary adenomas often have a relatively bland histological appearance despite their malignant growth patterns. We now report a case of a 67-years-old male with a giant pituitary tumor with overt pathologic and phenotypic features of malignancy, but the absence of metastases, that evolved from a benign non-functioning gonadotroph macroadenoma treated 10 years earlier. This case represents the first report of a pituitary adenoma with overt malignant histology that does not meet criteria for classification as pituitary carcinoma, helping to complete the pathological spectrum of disease observed with pituitary tumors.

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Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report

Cited by 27 publications

References 24 publications

Malignant prolactinoma: case report and review of the literature

Malignant prolactinoma: case report and review of the literature

Somatostatin-Producing Atypical Null Cell Adenoma Manifesting as Severe Hypopituitarism and Rapid Deterioration—Case Report

Atypical pituitary adenoma with malignant features

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