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Ectopic pituitary adenoma with malignant transformation.
Naoki Hosaka1, Shin-Ichiro Kitajiri, Harukazu Hiraumi
1Department of Clinical Pathology, Toyooka Hospital, Toyooka City, Hyogo, Japan.
The American Journal of Surgical Pathology
|August 10, 2002
Summary
This study documents the first reported case of malignant transformation in an ectopic pituitary adenoma. Key biomarkers indicate the tumor
Area of Science:
- Neuro-oncology
- Endocrinology
- Pathology
Background:
- Ectopic pituitary adenomas are rare tumors found outside the sella turcica.
- This case involves a follicle-stimulating hormone-producing adenoma in the nasal cavity with intracranial extension.
Observation:
- The tumor recurred three times within two years despite multiple surgical resections.
- Progressive cellular atypia, increased mitosis, necrosis, and elevated markers (proliferating cell nuclear antigen, MIB-1) were noted.
- p53 expression emerged by the second recurrence, preceding widespread metastasis.
Findings:
- The ectopic pituitary adenoma underwent malignant transformation, evidenced by aggressive growth and dissemination.
- The tumor spread to the subarachnoid space and metastasized within the brain.
- The patient succumbed to the malignancy 10 months after the final surgery.
Implications:
- This is the first documented instance of malignant transformation in an ectopic pituitary adenoma.
- Proliferating cell nuclear antigen, MIB-1, and p53 expression may serve as crucial indicators of malignant potential.
- Awareness of malignant transformation potential is vital for managing ectopic and sellar pituitary tumors.