title: ACTH-producing pituitary carcinoma presenting as the cauda equina syndrome.
abstract: A 43-year-old woman presented with incontinence, weakness, and paresthesia, consistent with the cauda equina syndrome, 10 years after having a pituitary tumor surgically removed and 4 years after excision of two "meningiomas" of the cervical cord. The patient was also hypertensive and had a cushingoid habitus. Emergent surgical decompression of the spinal cord revealed intradural metastatic adrenocorticotropic hormone-producing pituitary carcinoma. Pituitary carcinomas are rare. The majority of reported cases of adrenocorticotropic hormone-producing carcinoma have exhibited metastases outside the central nervous system. To our knowledge, this represents the first case of an adrenocorticotropic hormone-producing pituitary carcinoma presenting with the cauda equina syndrome. A review of all reported cases of pituitary carcinoma indicated that central nervous system metastases were more common than metastases to distant sites, and patients with distant metastases experienced a shorter duration of disease than did those with central nervous system metastases.
authors: Department of Pathology, George Washington University Hospital, Washington, DC 20037.
authors: A R
authors: AR
authors: Frost
authors: S
authors: S
authors: Tenner
authors: M
authors: M
authors: Tenner
authors: C
authors: C
authors: Rollhauser
authors: S O
authors: SO
authors: Tabbara
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis*; D000328:Adult; D002420:Cauda Equina; D003480:Cushing Syndrome / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009408:Nerve Compression Syndromes / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D013120:Spinal Cord Neoplasms / Q000097:blood / Q000150:complications / Q000556:secondary*
chemical_list: D000324:Adrenocorticotropic Hormone