Supradiaphragmatic ectopic adrenocorticotropic hormone-secreting adenoma.
A 22-year-old woman with Cushing's syndrome, caused by an extremely rare suprasellar ectopic pituitary adenoma, is presented. Magnetic resonance imaging and computed tomography revealed a well-circumscribed mass in the right suprasellar region. Endocrinological tests showed elevated s-adrenocorticotropic hormone level and hypercortisolemia. The tumor was totally removed by right subfrontal approach. At the time of the operation, the tumor was in continuity with the distal pituitary stalk but not with the pituitary gland. The diaphragma sellae was intact. Histologic diagnosis of the tumor specimen was confirmed as a pituitary adenoma. After surgical removal of the tumor, continued improvement in the patient's laboratory results and disappearance of her endocrine symptoms strongly indicated the absence of adenoma cells in the pituitary gland or stalk. Six years post-surgery, there was no evidence of recurrence in the patient's clinical and laboratory examination. This tumor probably originated from aberrant anterior pituitary cells of the pituitary stalk.
Jung
S
S
Departments of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam University Hospital and Medical School, Kwangju, Republic of Korea. sjung@chonnam.chonnam.ac.kr
Kim
J H
JH
Kim
T S
TS
Lee
M C
MC
Seo
J J
JJ
Park
J W
JW
Kang
S S
SS
D000236:Adenoma / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D000324:Adrenocorticotropic Hormone / Q000032:analysis / Q000378:metabolism*; D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000473:pathology; D010911:Pituitary Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D011859:Radiography; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000473:pathology*
D000324:Adrenocorticotropic Hormone