title: Extremely late development of pituitary carcinoma after surgery and radiotherapy.
abstract: BACKGROUND
  Pituitary carcinomas account for 0.1 or 0.2% of pituitary tumors. The authors report a rare case of a pituitary carcinoma mimicking a radio-induced meningioma.
  
  
  METHODS
  Fifty-five years-old male presents a previous history of transcranial surgery in 1983 for invasive pituitary adenoma followed by whole-brain radiotherapy (5100 cGy). After three years he presented worsening of visual deficits and MRI evidenced recurrence of the lesion. In 1992, he underwent a transcranial approach to treat recurrent supraselar disease, followed by stereoctatic radiotherapy. In 2006, clinical condition was stable; however three right frontal extra-axial lesions were diagnosed by MRI, compatible with meningioma. The histological examination revealed pituitary adenoma. No lesions were found in craniospinal axis. Further treatment was not recommended by radiotherapists due previous actinic treatments. Two years radiological follow-up revealed no recurrence.
  
  
  CONCLUSIONS
  In these high risk cases, active and constant surveillance must be pertained, regardless the time of follow-up.
authors.affiliation: Division of Neurological Surgery, University of São Paulo, School of Medicine, Rua Oscar Freire, 1456, Apt 34, Cep 05409-010, São Paulo, Brazil. ebgadelha@yahoo.com
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.forename: Wellingson Silva
authors.initials: WS
authors.lastname: Paiva
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
mesh_terms: D001932:Brain Neoplasms / Q000556:secondary*; D002277:Carcinoma / Q000473:pathology* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000473:pathology*; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000628:therapy; D011878:Radiotherapy