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Tumor invasion to the spinal region after primary surgery: A case report

BACKGROUND: It is believed that pituitary carcinoma is a rare disorder and arise from the transformation of benign invasive macroadenomas, and the process of this transformation takes place slowly. CASE PRESENTATION: A 51-year-old man presented with the clinical features of Cushing syndrome and walk...

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Autores principales: Davoudi, Zahra, Chouhdari, Arezoo, Sharifi, Guive, Akbari Dilmaghani, Nader
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Babol University of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559627/
https://www.ncbi.nlm.nih.gov/pubmed/34760107
http://dx.doi.org/10.22088/cjim.12.0.467
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author Davoudi, Zahra
Chouhdari, Arezoo
Sharifi, Guive
Akbari Dilmaghani, Nader
author_facet Davoudi, Zahra
Chouhdari, Arezoo
Sharifi, Guive
Akbari Dilmaghani, Nader
author_sort Davoudi, Zahra
collection PubMed
description BACKGROUND: It is believed that pituitary carcinoma is a rare disorder and arise from the transformation of benign invasive macroadenomas, and the process of this transformation takes place slowly. CASE PRESENTATION: A 51-year-old man presented with the clinical features of Cushing syndrome and walking impairment who was diagnosed with metastatic corticotroph pituitary carcinoma to the spine region, 6 years after the initial resection of a primary invasive pituitary adenoma. He made a visit to neurosurgery and endocrinology clinic with the chief complaint of weight gain, facial and extremities swelling, paresthesia, weakness, motion and speaking impairments, and HTN which all appeared through the last 1 year; hormonal laboratory tests showed urine free cortisol (UFC) 197.8 and 367. 30 ug/24hrs (36-137), cortisol 8 am after 1 mg overnight dexamethasone test 375 ng/mL (50-250) and ACTH 59 pg/mL. MRI study revealed a mass in the brainstem with the compression effect on spinal region, pituitary imagine does not differ from the last MRI. He underwent a neurosurgery for spinal mass resection, which was successful and the total mass was resected. After surgery, the patient's condition became better. CONCLUSION: Pituitary carcinoma is a rare entity impossible to recognize as a primary tumor because its diagnosis by definition requires the presence of metastasis. Clinical awareness of the rare possibility for aggressive adenomas will progress, to metastasize is essential to appropriately monitor patients for possible early detection and treatment of pituitary carcinoma.
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spelling pubmed-85596272021-11-09 Tumor invasion to the spinal region after primary surgery: A case report Davoudi, Zahra Chouhdari, Arezoo Sharifi, Guive Akbari Dilmaghani, Nader Caspian J Intern Med Case Report BACKGROUND: It is believed that pituitary carcinoma is a rare disorder and arise from the transformation of benign invasive macroadenomas, and the process of this transformation takes place slowly. CASE PRESENTATION: A 51-year-old man presented with the clinical features of Cushing syndrome and walking impairment who was diagnosed with metastatic corticotroph pituitary carcinoma to the spine region, 6 years after the initial resection of a primary invasive pituitary adenoma. He made a visit to neurosurgery and endocrinology clinic with the chief complaint of weight gain, facial and extremities swelling, paresthesia, weakness, motion and speaking impairments, and HTN which all appeared through the last 1 year; hormonal laboratory tests showed urine free cortisol (UFC) 197.8 and 367. 30 ug/24hrs (36-137), cortisol 8 am after 1 mg overnight dexamethasone test 375 ng/mL (50-250) and ACTH 59 pg/mL. MRI study revealed a mass in the brainstem with the compression effect on spinal region, pituitary imagine does not differ from the last MRI. He underwent a neurosurgery for spinal mass resection, which was successful and the total mass was resected. After surgery, the patient's condition became better. CONCLUSION: Pituitary carcinoma is a rare entity impossible to recognize as a primary tumor because its diagnosis by definition requires the presence of metastasis. Clinical awareness of the rare possibility for aggressive adenomas will progress, to metastasize is essential to appropriately monitor patients for possible early detection and treatment of pituitary carcinoma. Babol University of Medical Sciences 2021 /pmc/articles/PMC8559627/ /pubmed/34760107 http://dx.doi.org/10.22088/cjim.12.0.467 Text en https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/ (https://creativecommons.org/licenses/by/3.0/) ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Davoudi, Zahra
Chouhdari, Arezoo
Sharifi, Guive
Akbari Dilmaghani, Nader
Tumor invasion to the spinal region after primary surgery: A case report
title Tumor invasion to the spinal region after primary surgery: A case report
title_full Tumor invasion to the spinal region after primary surgery: A case report
title_fullStr Tumor invasion to the spinal region after primary surgery: A case report
title_full_unstemmed Tumor invasion to the spinal region after primary surgery: A case report
title_short Tumor invasion to the spinal region after primary surgery: A case report
title_sort tumor invasion to the spinal region after primary surgery: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559627/
https://www.ncbi.nlm.nih.gov/pubmed/34760107
http://dx.doi.org/10.22088/cjim.12.0.467
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