title: Primary Sellar Rhabdomyosarcoma Arising in Association With a Pituitary Adenoma.
abstract: Intrasellar rhabdomyosarcoma is rare, and when arising in collusion with an unrelated entity, can present a diagnostic pitfall. We describe a case of a 56-year-old woman who presented with right eye ptosis and a pituitary mass, which was resected and diagnosed as atypical pituitary adenoma. Because of residual disease and atypical pathology, the patient received adjuvant radiation. Tumor recurrence was noted after 5 months, and a second resection was performed. Nests of atypical pituitary adenoma cells within an exuberant spindle cell stroma were noted, with areas of presumed radiation necrosis. A second recurrence prompted a third resection. After expert consultation and additional immunohistochemical stains for muscle markers, a diagnosis was rendered of primary rhabdomyosarcoma arising in association with a pituitary adenoma. Despite its rarity, a high index of suspicion for rhabdomyosarcoma arising within a pituitary adenoma should be maintained in cases of atypical pituitary adenoma with a stromal response.
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA veduncan@uabmnc.edu.
authors.forename: Virginia E
authors.initials: VE
authors.lastname: Duncan
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: L Burt
authors.initials: LB
authors.lastname: Nabors
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Paula P
authors.initials: PP
authors.lastname: Warren
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Conry
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Willey
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Arie
authors.initials: A
authors.lastname: Perry
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Kristen O
authors.initials: KO
authors.lastname: Riley
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hackney
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000473:pathology*; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: atypical pituitary adenoma; rhabdomyosarcoma