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Aggressive pituitary lesion with a remarkably high Ki-67
Pedro Marques1, Manuela Mafra2, Carlos Calado3
1Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisboa, Portugal.
Arquivos Brasileiros De Endocrinologia E Metabologia
|September 12, 2014
Summary
Extremely aggressive pituitary tumors, diagnosed by metastasis, often resist treatment. This case highlights a rare, rapidly fatal pituitary carcinoma with a high Ki-67 index, suggesting its prognostic value.
Area of Science:
- Neuro-oncology
- Endocrinology
- Pathology
Background:
- Pituitary carcinomas are rare, aggressive tumors defined by metastasis.
- Most pituitary tumors present with local symptoms rather than hormonal overproduction.
- Current treatments for these neoplasias often show limited efficacy.
Observation:
- A 51-year-old woman presented with sudden neurological deficits including headache and left arm paresis.
- Imaging revealed a pituitary tumor invading adjacent sinuses; histology showed a high Ki-67 index (75%).
- Despite surgery and radiotherapy, the patient experienced rapid progression and died within two months.
Findings:
- This case represents an exceptionally aggressive pituitary neoplasm with a very high Ki-67 index and rapid mortality.
- The patient's rapid decline underscores the limited effectiveness of current therapeutic strategies.
- The high Ki-67 index in this case suggests potential prognostic significance for pituitary tumors.
Implications:
- The Ki-67 index may serve as a valuable prognostic marker for pituitary tumors.
- Current pituitary tumor classification systems, like the World Health Organization (WHO) system, may require revision.
- Further research is needed to develop more effective treatments for aggressive pituitary carcinomas.
