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Pituitary carcinomas: Rare and challenging

BACKGROUND: Pituitary carcinomas (PCs) are defined as adenohypophyseal tumors with metastatic activity within and outside the boundaries of the central nervous system (CNS). The condition is rare and therefore seldom reported; most lesions are hormone producing and have a tendency for complex evolut...

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Autores principales: Sinclair, Georges, Olsson, Martin, Benmakhlouf, Hamza, Al-saffar, Yahya, Johnstone, Philippa, Hatiboglu, Mustafa Aziz, Shamikh, Alia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744763/
https://www.ncbi.nlm.nih.gov/pubmed/31528496
http://dx.doi.org/10.25259/SNI_112_2019
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author Sinclair, Georges
Olsson, Martin
Benmakhlouf, Hamza
Al-saffar, Yahya
Johnstone, Philippa
Hatiboglu, Mustafa Aziz
Shamikh, Alia
author_facet Sinclair, Georges
Olsson, Martin
Benmakhlouf, Hamza
Al-saffar, Yahya
Johnstone, Philippa
Hatiboglu, Mustafa Aziz
Shamikh, Alia
author_sort Sinclair, Georges
collection PubMed
description BACKGROUND: Pituitary carcinomas (PCs) are defined as adenohypophyseal tumors with metastatic activity within and outside the boundaries of the central nervous system (CNS). The condition is rare and therefore seldom reported; most lesions are hormone producing and have a tendency for complex evolution. As such, the management of PCs remains difficult. We present an illustrative case of PC with a brief review of the recent medical literature. CASE DESCRIPTION: A 58-year-old patient was diagnosed with prolactinoma in 2005. The ensuing biochemical and radiological evolution proved contentious; local tumor control was never fully achieved despite multimodal management including pharmacological treatment, repeated resections, and radiotherapy. In late 2017, the patient developed metastatic lesions within the confinements of the CNS requiring further surgical interventions, high-dose radiation, and systemic treatment. CONCLUSION: As it was the case in our patient, PCs require tailored, multimodal treatments according to the degree of infiltration, site of invasion, and hormone status. Further studies are necessary to understand the mechanisms promoting “extra-sellar” activity, particularly at distant sites; the identification of biomarkers exposing the risk of PC remains a crucial aspect of diagnostics, prevention and future customized therapies.
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spelling pubmed-67447632019-09-16 Pituitary carcinomas: Rare and challenging Sinclair, Georges Olsson, Martin Benmakhlouf, Hamza Al-saffar, Yahya Johnstone, Philippa Hatiboglu, Mustafa Aziz Shamikh, Alia Surg Neurol Int Case Report BACKGROUND: Pituitary carcinomas (PCs) are defined as adenohypophyseal tumors with metastatic activity within and outside the boundaries of the central nervous system (CNS). The condition is rare and therefore seldom reported; most lesions are hormone producing and have a tendency for complex evolution. As such, the management of PCs remains difficult. We present an illustrative case of PC with a brief review of the recent medical literature. CASE DESCRIPTION: A 58-year-old patient was diagnosed with prolactinoma in 2005. The ensuing biochemical and radiological evolution proved contentious; local tumor control was never fully achieved despite multimodal management including pharmacological treatment, repeated resections, and radiotherapy. In late 2017, the patient developed metastatic lesions within the confinements of the CNS requiring further surgical interventions, high-dose radiation, and systemic treatment. CONCLUSION: As it was the case in our patient, PCs require tailored, multimodal treatments according to the degree of infiltration, site of invasion, and hormone status. Further studies are necessary to understand the mechanisms promoting “extra-sellar” activity, particularly at distant sites; the identification of biomarkers exposing the risk of PC remains a crucial aspect of diagnostics, prevention and future customized therapies. Scientific Scholar 2019-08-09 /pmc/articles/PMC6744763/ /pubmed/31528496 http://dx.doi.org/10.25259/SNI_112_2019 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Sinclair, Georges
Olsson, Martin
Benmakhlouf, Hamza
Al-saffar, Yahya
Johnstone, Philippa
Hatiboglu, Mustafa Aziz
Shamikh, Alia
Pituitary carcinomas: Rare and challenging
title Pituitary carcinomas: Rare and challenging
title_full Pituitary carcinomas: Rare and challenging
title_fullStr Pituitary carcinomas: Rare and challenging
title_full_unstemmed Pituitary carcinomas: Rare and challenging
title_short Pituitary carcinomas: Rare and challenging
title_sort pituitary carcinomas: rare and challenging
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744763/
https://www.ncbi.nlm.nih.gov/pubmed/31528496
http://dx.doi.org/10.25259/SNI_112_2019
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