Juxtaposition of an ectopic corticotroph adenoma of the sphenoid sinus with orthotopic intrasellar corticotroph hyperplasia in a patient with Cushing disease. Case report.
Ectopic pituitary adenomas (EPAs) are rare and their association with orthotopic corticotroph hyperplasia has not been published. The case of a 30-year-old woman with clinical and biochemical evidence of Cushing disease (CD) is reported. A magnetic resonance image obtained preoperatively revealed asymmetrical inhomogeneity of the pituitary gland, which was suggestive of localized adenoma. It also showed what was thought to be a small sphenoid polyp. Postoperatively the latter lesion was found to be an ectopic corticotroph adenoma. The pituitary gland, which was free from any tumor, exhibited diffuse unilateral corticotroph hyperplasia. Clinical, radiological, laboratory, and histopathological findings are presented. A review of the literature and a discussion of possible causes of this unique association between the ectopic corticotroph adenoma and the pituitary hyperplasia are provided.
Al-Gahtany
Mubarak
M
Department of Neurosurgery, St. Michael's Hospital and University of Toronto, Ontario, Canada. mubarak.al.gahtany@utoronto.ca
Bilbao
Juan
J
Kovacs
Kalman
K
Horvath
Eva
E
Smyth
Harley S
HS
D000182:ACTH Syndrome, Ectopic / Q000150:complications*; D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D000328:Adult; D003480:Cushing Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010255:Paranasal Sinus Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D012658:Sella Turcica / Q000473:pathology*; D013101:Sphenoid Sinus / Q000473:pathology*