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Pituitary atypical adenoma or malignant corticotrophinoma?.


 
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1. Title Title of document Pituitary atypical adenoma or malignant corticotrophinoma?.
 
2. Creator Author's name, affiliation, country Márcia Alves; Serviço de Endocrinologia, Diabetes e Metabolismo, Hospitais da Universidade de Coimbra, Coimbra, Portugal.; Portugal
 
2. Creator Author's name, affiliation, country Isabel Paiva; Portugal
 
2. Creator Author's name, affiliation, country Francisco Belo; Portugal
 
2. Creator Author's name, affiliation, country Olinda Rebelo; Portugal
 
2. Creator Author's name, affiliation, country Margarida Bastos; Portugal
 
2. Creator Author's name, affiliation, country Manuela Carvalheiro; Portugal
 
3. Subject Discipline(s)
 
3. Subject Keyword(s)
 
4. Description Abstract Pituitary tumors are classified into typical adenomas, atypical adenomas or carcinomas. Carcinoma represents 0.2% of pituitary tumors and is defined by the presence of metastases. It often presents as invasive and secreting macroadenoma, showing features of malignancy ab initio or over time. The high proliferative index (Ki-67) and immunostaining for p53 protein are common indicators of aggressiveness. We report a 58 years old male with invasive sellar incidentaloma. The hormonal study showed gonadal, thyroid, and somatotrophic failure, with increase of corticotropin (ACTH) and cortisol. Transsphenoidal surgery was performed and histology revealed a typical corticotrophinoma. The successive recurrences over 10 years led to five surgical reoperation and radiotherapy. After the third surgery, cellular atypia, Ki-67 of 27% and immunostaining for p53 were revealed. Subsequently, there were lesions suspicious of metastases (lung and lymph nodes), but the biopsy of the lymph nodes was inconclusive. The patient died before chemotherapy. In this case, the progressive loss of differentiation points to the need for early diagnosis, timely and aggressive treatment.
 
5. Publisher Organizing agency, location Ordem dos Médicos
 
6. Contributor Sponsor(s)
 
7. Date (YYYY-MM-DD) 2011-12-30
 
8. Type Status & genre article
 
8. Type Type
 
9. Format File format PDF (Português)
 
10. Identifier Uniform Resource Identifier https://actamedicaportuguesa.com/revista/index.php/amp/article/view/1544
 
10. Identifier Digital Object Identifier (DOI) http://dx.doi.org/10.20344/amp.1544
 
11. Source Title; vol., no. (year) Acta Médica Portuguesa; Vol 24 (2011): Suplemento 3
 
12. Language English=en
 
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
 
15. Rights Copyright and permissions Copyright (c)