title: Long-term survival with ACTH-secreting carcinoma of the pituitary: a case report and review of the literature.
abstract: A 48-yr-old woman was evaluated 21 yr after receiving treatment for an ACTH-secreting metastatic pituitary carcinoma. She had been diagnosed with Cushing's disease 35 yr earlier at the age of 14 yr and had undergone bilateral adrenalectomy. Six years later she developed Nelson's syndrome, which was treated with resection of a pituitary adenoma followed by radiotherapy to the sella turcica. Eight years later she was found to have craniospinal metastases with three remote intracerebral lesions. Two of these lesions were surgically resected and stained positive for ACTH by immunofluorescence. She subsequently received whole-brain radiotherapy and is doing well 21 yr later with no lesions seen on magnetic resonance imaging and no evidence of recurrent metastatic disease. We present this case in detail along with a literature review of ACTH-secreting pituitary carcinoma.
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.
authors.forename: Rita E
authors.initials: RE
authors.lastname: Landman
authors.forename: Melvin
authors.initials: M
authors.lastname: Horwith
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Peterson
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Khandji
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Wardlaw
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary / Q000601:surgery; D011878:Radiotherapy; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D000324:Adrenocorticotropic Hormone