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Pituitary Carcinoma with Subependymal Spread

Published online by Cambridge University Press:  02 December 2014

Krishna Kumar ,
Jefferson R. Wilson ,
Qiuyan Li  and
Ryan Phillipson
Krishna Kumar*
Affiliation:
Section of Neurosurgery, Department of Surgery, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada
Jefferson R. Wilson
Affiliation:
Section of Neurosurgery, Department of Surgery, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada
Qiuyan Li
Affiliation:
Department of Pathology, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada
Ryan Phillipson
Affiliation:
Department of Radiology, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada
*
Regina General Hospital, Medical Office Wing, 1440 14th Avenue, Regina, Saskatchewan, S4P 0W5, Canada
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Pituitary carcinomas have been reported to metastasize systemically and, less commonly, along the craniospinal axis. Metastatic lesions have been reported in the cerebral cortex, cerebellum, spinal cord, leptomeninges, cervical lymph nodes, liver, ovaries, and bone. The authors are unaware of any other examples of subependymal metastases of a pituitary carcinoma. We report such a case.

Pituitary carcinoma is rare, accounting for roughly 0.2%1,3-5 of all pituitary tumors, with approximately 140 cases reported in the literature. These tumors are associated with a very high mortality, with 66% of patients dying within the first year after diagnosis. Pituitary carcinomas are differentiated from invasive pituitary adenomas by the presence of non-contiguous craniospinal tumor deposits and/or distant systemic metastases. The majority (88%) of these carcinomas prove to be hormone secreting, with prolactin secreting tumors being the most common. Invasive carcinomas evolve from hormone secreting pituitary adenomas after a latency period. Pituitary carcinomas have a predilection for systemic spread. The rate of systemic metastasis approaches 71% for prolactin producing tumors and 57% for ACTH producing tumors. Thirteen percent of tumors demonstrate both systemic and craniospinal patterns of metastatic spread.

Type
Peer Reviewed Letter
Information
Canadian Journal of Neurological Sciences , Volume 33 , Issue 3 , August 2006 , pp. 329 - 332
Copyright
Copyright © The Canadian Journal of Neurological 2006

References

1. Pernicone, PJ, Scheithauer, BW, Sebo, TJ, Kovacs, KT, Horvath, E, Young, WF, et al. Pituitary carcinoma: a clinicopathological study of 15 cases. Cancer. 1997; 79: 804–12.Google Scholar
2. Ragel, BT, Couldwell, WT. Pituitary carcinoma: a review of the literature. Neurosurg. 2004; Focus 16: E7.Google Scholar
3. Pernicone, PJ, Scheithauer, BW. Invasive pituitary adenoma and pituitary carcinoma. Major Prob Pathol. 1993; 27: 121–36.Google Scholar
4. Pichard, C, Gerber, S, Laloi, M, Kujas, M, Clemenceau, S, Ponvert, D, et al. Pituitary carcinoma: report of an exceptional case and review of the literature. J Endocrinol Invest. 2002; 25: 65–72.Google Scholar
5. Kaltsas, GA, Grossman, AB. Malignant pituitary tumors. Pituitary. 1998; 1: 69–81.Google Scholar
6. Scheithauer, BW, Kurtkaya-Yapicier, O, Kovacs, KT, Young, WF, Lloyd, RV. Pituitary carcinoma: a clinicopathological review. Neurosurgery. 2005; 56: 1066–73.Google Scholar
7. Lehman, NL, Horoupian, DS, Harsh, GR 4th. Synchronous subarachnoid drop metastases from a pituitary adenoma with multiple recurrences: case report. J Neurosurg. 2003; 98: 1120–3.CrossRefGoogle ScholarPubMed
8. Kumar, K, Macaulay, RJB, Michael, Kelly, Pirlot, T. Absent p53: absent p53 immunohistochemical staining in a pituitary carcinoma. Can J Neuro Sci. 2001; 28: 174–8.Google Scholar
9. Thapar, K, Kovacs, K, Scheithauer, BW, Stefaneanu, L, Horvath, E, Pernicone, PJ. Proliferative activity and invasiveness among pituitary adenomas and carcinomas: an analysis using the MIB-1 antibody. Neurosurgery. 1996; 38: 99–107.Google Scholar
10. McCutcheon, IE, Pieper, DR, Fuller, GN, Benjamin, RS, Friend, KE, Gagel, RF. Pituitary carcinoma containing gonadotropins: treatment by radical excision and cytotoxic chemotherapy: case report. Neurosurgery. 2000; 46: 1233–40.Google Scholar