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Ectopic corticotroph adenoma in the cavernous sinus: case report
1Department of Neurosurgery and Internal Medicine, Nippon Medical School, Tokyo, Japan.
Neurosurgery
|October 9, 1999
Summary
Ectopic ACTH-secreting adenomas in the cavernous sinus can cause Cushing's disease. Postmortem examination revealed such a tumor, explaining diagnostic challenges and treatment failures in a patient.
Area of Science:
- Endocrinology
- Neurosurgery
- Pathology
Background:
- Cushing's disease is often caused by adrenocorticotropin (ACTH)-secreting pituitary adenomas.
- These adenomas can be challenging to locate due to variable positions and small sizes.
Observation:
- A 62-year-old woman with Cushing's disease had negative pituitary imaging but positive bilateral cavernous sinus sampling for ACTH.
- Postmortem histology revealed an ACTH-secreting adenoma within the right cavernous sinus, separate from the pituitary gland.
Findings:
- Ectopic ACTH-secreting adenomas in the cavernous sinus are rare but can mimic pituitary-dependent Cushing's disease.
- The tumor's location explained the diagnostic difficulties, including misleading cavernous sinus sampling results.
Implications:
- Recognition of ectopic cavernous sinus adenomas is crucial for accurate diagnosis of ACTH-dependent Cushing's syndrome.
- These findings highlight potential causes for the failure of standard diagnostic and surgical approaches in select Cushing's disease cases.