title: Metastatic prolactinoma: case report with immunohistochemical assessment for p53 and Ki-67 antigens.
abstract: Pituitary carcinomas are rare neoplasms characterized by craniospinal and/or systemic metastases originated from the pituitary. Their histopathology is frequently indistinguishable from that of benign adenomas. The development of markers that better reflect their behavior is desirable. We present the case of a 47 year-old man with a prolactin-secreting macroadenoma who was submitted to surgeries, cranial radiation therapy, and bromocriptine treatment, but evolved to a fatal outcome after the disclosure of intracranial metastases. Tumor samples underwent p53 and Ki-67 immunohistochemical assessment. p53 was absent in all samples, a rare finding among pituitary carcinomas. Ki-67 proliferative index was 2.80% in the original tumor, 4.40% in the relapse, and 4.45% in the metastasis. The figure in the relapse is higher than the expected for a noninvasive adenoma. In conclusion, p53 staining is not positive in all pituitary carcinomas. A high Ki-67 proliferative index in a pituitary adenoma might indicate a more aggressive behavior.
authors.affiliation: Institute of Neurology and Neurosurgery, Passo Fundo, RS, Brazil.
authors.forename: Paulo S
authors.initials: PS
authors.lastname: Crusius
authors.forename: Cassiano M
authors.initials: CM
authors.lastname: Forcelini
authors.forename: Adroaldo B
authors.initials: AB
authors.lastname: Mallmann
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Silveira
authors.forename: Elder
authors.initials: E
authors.lastname: Lersch
authors.forename: Cláudio A
authors.initials: CA
authors.lastname: Seibert
authors.forename: Marcelo U
authors.initials: MU
authors.lastname: Crusius
authors.forename: Charles A
authors.initials: CA
authors.lastname: Carazzo
authors.forename: Cassiano U
authors.initials: CU
authors.lastname: Crusius
authors.forename: Eduardo
authors.initials: E
authors.lastname: Goellner
mesh_terms: D000974:Antibodies, Antinuclear / Q000032:analysis; D000911:Antibodies, Monoclonal / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D017809:Fatal Outcome; D016158:Genes, p53; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D011859:Radiography; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; C440408:MIB-1 antibody; D011388:Prolactin