Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Thu, Mar 20, 2025
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Volume 12 - Case Supplement
Caspian J Intern Med 2021, 12 - Case Supplement : 467-470 |
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Davudi Z, Chouhdari A, Sharifi G, Akbari dilmaghani N. Tumor invasion to the spinal region after primary surgery: A case report. Caspian J Intern Med 2021; 12 (S2) :467-470
URL: http://caspjim.com/article-1-1783-en.html
URL: http://caspjim.com/article-1-1783-en.html
Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , gibnow@yahoo.com
Abstract: (2385 Views)
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.
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.
Type of Study: case report |
Subject:
Neurology
Received: 2019/02/26 | Accepted: 2019/12/15 | Published: 2021/07/24
Received: 2019/02/26 | Accepted: 2019/12/15 | Published: 2021/07/24
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