World neurosurgery · 2011
Neuroendocrine tumor of unknown origin metastasizing to a growth hormone-secreting pituitary adenoma.
Клинический случайСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Nassiri Farshad, Cusimano Michael, Rotondo Fabio, Horvath Eva, Kovacs Kalman
Аннотация
BACKGROUND: Metastasis of a neuroendocrine tumor to the anterior pituitary is extremely rare.
METHODS: A 55-year-old woman presented with features suggestive of acromegaly and bone and joint pain. A bone scan suggested metastatic disease. A biopsy of the lumbar spinal lesions revealed a neuroendocrine tumor. Magnetic resonance imaging of the sella demonstrated a lesion with parasellar and suprasellar extensions. Given the need for tissue diagnosis and optic compression, the sellar lesion was removed via transsphenoidal hypophysectomy.
RESULTS: Histology of the biopsy indicated two different tumors in close association. One showed histological features of a pituitary adenoma, whereas the other was a neuroendocrine carcinoma. The pituitary adenoma was immunopositive for growth hormone (GH), whereas the neuroendocrine carcinoma was immunopositive for serotonin and bombesin and immunonegative for GH.
CONCLUSIONS: This is the first report of a serotonin and bombesin immunopositive neuroendocrine tumor of unknown primary origin metastatic to a GH-secreting pituitary adenoma, resulting in acromegaly.
METHODS: A 55-year-old woman presented with features suggestive of acromegaly and bone and joint pain. A bone scan suggested metastatic disease. A biopsy of the lumbar spinal lesions revealed a neuroendocrine tumor. Magnetic resonance imaging of the sella demonstrated a lesion with parasellar and suprasellar extensions. Given the need for tissue diagnosis and optic compression, the sellar lesion was removed via transsphenoidal hypophysectomy.
RESULTS: Histology of the biopsy indicated two different tumors in close association. One showed histological features of a pituitary adenoma, whereas the other was a neuroendocrine carcinoma. The pituitary adenoma was immunopositive for growth hormone (GH), whereas the neuroendocrine carcinoma was immunopositive for serotonin and bombesin and immunonegative for GH.
CONCLUSIONS: This is the first report of a serotonin and bombesin immunopositive neuroendocrine tumor of unknown primary origin metastatic to a GH-secreting pituitary adenoma, resulting in acromegaly.
Предметные рубрики MeSH
AcromegalyBiopsyBombesinBone and BonesFemaleGrowth Hormone-Secreting Pituitary AdenomaHuman Growth HormoneHumansHypophysectomyImmunohistochemistryLumbosacral RegionMagnetic Resonance ImagingMicroscopy, ElectronMiddle AgedNeuroendocrine TumorsNeurosurgical ProceduresPituitary GlandPituitary NeoplasmsRadiographySerotoninSpine