Gonadotroph neuroendocrine tumor of the pituitary gland (PitNET): a rare incidental finding on CBCT

Pituitary neuroendocrine tumors (PitNET) comprise 15% of all primary brain tumors. As these tumors arise from cells producing various hormones, they are classified as either functional or non-functional. Non-functional PitNETs are diagnosed based on symptoms of mass effect or are incidental findings (IFs) during radiologic examination. This is a case presentation of an incidental finding of a gonadotroph-neuroendocrine tumor.

A patient presented to the Dental School for fabrication of complete maxillary and mandibular overdentures. A cone-beam computed tomography (CBCT) was acquired for treatment planning purposes and was interpreted by Oral and Maxillofacial Radiology. Upon examination, enlargement of the sella turcica was detected in the medio-lateral direction, measuring approximately 26 mm, and 21 mm antero-posteriorly, on coronal and sagittal slices, respectively, with the contents of the sella protruding towards the sphenoid sinus. Findings were suggestive of either a benign neoplastic process or empty sella syndrome. A prior MRI scan revealed a 4.6 cm pituitary PitNET with suprasellar extension. The patient underwent endoscopic transsphenoidal resection and the tumor was diagnosed as gonadotroph neuroendocrine tumor based on the histopathologic examination and immunohistochemical studies.

CBCT examinations acquired for dental purposes often include the base of the skull, which can result in incidental findings, like PitNETs. Even though CBCT does not have adequate soft tissue contrast to differentiate such pathosis, the mass effect of these tumors on adjacent bony structures can be detected, thus emphasizing the need for careful evaluation of the full volume of the CBCT scan.