Late development of intraventricular papillary pituitary carcinoma after irradiation of prolactinoma.
BACKGROUND
Intracranial dissemination of pituitary adenomas is a rare event that does not equate malignancy. Most of the cases have been reported as metastases from pituitary carcinoma. A case of papillary pituitary carcinoma developed 12 years after radiotherapy for prolactin-secreting hormone pituitary adenoma is presented.


METHODS
A 37-year-old woman was admitted for the second time with neurologic disturbance and hypertension. A gadolinium-enhanced magnetic resonance scan of the brain demonstrated a 50-mm enhanced mass (absent on previous studies) on the lateral ventricle, involving the left temporal lobe. The patient underwent a craniotomy and biopsy of the lesion that was consistent with pituitary carcinoma; it was immunoreactive to follicle-stimulating hormone, adrenocorticotropic hormone, pituitary tumor-transforming gene, and epithelial cell adhesion molecule. Transmission electron microscopy analysis confirmed the secretory pituitary tumor diagnosis.


CONCLUSIONS
The tumor was considered a primary pituitary papillary carcinoma. The clinical course indicated that this tumor was the seedling of a pituitary tumor, although it could be interpreted as metastases from a pituitary carcinoma.
Tena-Suck
Martha Lilia
ML
Department of Neuropathology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Delegación Tlalpan CP 14269, Mexico City, Mexico.
Salinas-Lara
Citlaltepetl
C
Sánchez-García
Aurora
A
Rembao-Bojórquez
Daniel
D
Ortiz-Plata
Alma
A
D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D052682:Lactotrophs / Q000473:pathology / Q000528:radiation effects; D020547:Lateral Ventricles / Q000473:pathology; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010902:Pituitary Gland / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D013995:Time; D013997:Time Factors
D014408:Biomarkers, Tumor