title: Malignant evolution of an ACTH-producing pituitary tumor treated with intrasellar implantation of 90Y. Case report and review of the literature.
abstract: A case of pituitary carcinoma is here presented, together with a review of the 25 cases so far reported in the literature. After a long-standing history of Cushing's disease, treated with interstitial pituitary irradiation and total adrenalectomy, Nelson's syndrome developed due to a pituitary neoplasm that finally spread through the subarachnoidal space, bringing the patient to death. The possible long-term role of surgery and radiotherapy in switching an aggressive behavior is also discussed.
mesh_terms: D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D003480:Cushing Syndrome / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008854:Microscopy, Electron; D009347:Nelson Syndrome / Q000209:etiology; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed; D015021:Yttrium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D015021:Yttrium Radioisotopes; D000324:Adrenocorticotropic Hormone