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Functioning ectopic supradiaphragmatic pituitary adenomas

E H Dyer1, T Civit, J P Abecassis

  • 1Department of Neurosurgery, Cochin Hospital, Paris, France.

Neurosurgery
|March 1, 1994
PubMed
Summary
This summary is machine-generated.

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Rare functional pituitary adenomas located above the pituitary gland present diagnostic and treatment challenges. These supradiaphragmatic tumors, including ACTH and prolactin-secreting adenomas, often require specialized surgical approaches beyond the standard transsphenoidal route.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Pathology

Background:

  • Pituitary adenomas typically originate within the sella turcica.
  • Adenomas located outside the gland are rare, often linked to developmental anomalies.
  • Suprasellar adenomas are usually clinically nonfunctioning and may arise from ectopic pituitary cells.

Observation:

  • This study details four cases of functional pituitary adenomas exclusively in the supradiaphragmatic region.
  • Tumors included three adrenocorticotrophic hormone (ACTH)-secreting and one prolactin-secreting adenoma.
  • These functional adenomas were located superior to the diaphragma sellae.

Findings:

  • The observed functional adenomas were confined to the supradiaphragmatic area, distinct from typical intrasellar origins.

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  • Initial treatment attempts via the transsphenoidal approach were unsuccessful due to the tumors' location.
  • This suggests a specific embryological origin or migration pattern for these ectopic functional adenomas.

    • Implications:

    • The findings highlight the existence of rare, functional pituitary adenomas in the supradiaphragmatic region.
    • Standard transsphenoidal surgery may be inadequate for these anatomically distinct tumors.
    • Further research into the embryogenesis and optimal surgical strategies for supradiaphragmatic pituitary adenomas is warranted.