[ACTH producing pituitary adenoma with multiple intracranial metastases and spinal dissemination]

A 34-year-old male developed multiple intracranial and intraspinal metastases from an invasive ACTH secreting pituitary adenoma. He was initially admitted to our hospital complaining of visual loss 10 years ago, presenting a pituitary tumor with suprasellar extension. At first, transsphenoidal surgery was performed, and histological finding was pituitary apoplexy. He developed recurrence of the tumor 2 times. At the second, third and fourth operation, the histological finding was an ACTH secreting pituitary adenoma with atypia. Metastases within the central-nervous system of pituitary adenoma is a rare entity and only 21 cases have been published. A review of previously published cases follows.