title: Lesions of the petrous ridge: metastatic pituitary carcinoma with discussion of differential diagnosis.
abstract: OBJECTIVE
  To discuss the differential diagnosis of petrous ridge lesions based on a rare case of metastatic pituitary carcinoma.
  
  
  METHODS
  A 41-year-old man with a past medical history of pituitary adenoma and hypopituitarism presented with imbalance and vertigo. Imaging showed a mass eroding the left posterior petrous face.
  
  
  METHODS
  Transtemporal, transmastoid approach for complete resection of tumor.
  
  
  METHODS
  Surgical pathology and imaging studies.
  
  
  RESULTS
  Surgical pathology revealed metastatic pituitary carcinoma. The patient has been followed at our institution for 28 months postoperatively without evidence of recurrence.
  
  
  CONCLUSIONS
  Lesions of the petrous ridge are rare. The wide differential diagnosis includes endolympatic sac tumor, meningioma, jugulotympanic paraganglioma, myeloma, and metastasis. The clinician must take into account unique imaging features on CT and MRI, and final diagnosis often requires pathologic analysis.
authors.affiliation: Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A.
authors.forename: Giant C
authors.initials: GC
authors.lastname: Lin
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Adams
authors.forename: H Alexander
authors.initials: HA
authors.lastname: Arts
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary*; D003937:Diagnosis, Differential; D004712:Endolymphatic Sac / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010579:Petrous Bone / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000473:pathology*; D011388:Prolactin / Q000378:metabolism; D012888:Skull Neoplasms / Q000556:secondary*; D013701:Temporal Bone / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D011388:Prolactin