Pituitary carcinoma with a single metastasis causing cervical spinal cord compression. Case report.
Pituitary carcinoma is rare, with fewer than 100 cases having been reported in the English-language literature. The diagnosis of pituitary carcinoma requires the demonstration of cerebrospinal and/or systemic metastases rather than local invasion. The lesion carries a poor prognosis; fewer than 50% of patients survive beyond 1 year after diagnosis. In this report the authors describe the case of a 68-year-old man who had undergone transsphenoidal debulking surgery and pituitary radiotherapy 4 years earlier for a pituitary adenoma. He presented with cervical cord compression due to a single metastasis from pituitary carcinoma. The authors discuss the management of this entity and review the literature for current opinion on the pathogenesis of these tumors, factors resulting in malignant transformation, and the reliability of markers that predict future malignant behavior. Evidence for the various treatment modalities is also appraised.
Ayuk
John
J
Division of Medical Sciences, The Cancer Centre, Department of Neurosurgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, England.
Natarajan
Geetha
G
Geh
J Ian
JI
Mitchell
Rosalind D
RD
Gittoes
Neil J L
NJ
D000236:Adenoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D002574:Cervical Vertebrae; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010784:Photomicrography; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology*