title: Malignant adenohypophysis spindle cell oncocytoma with repeating recurrences and a high Ki-67 index.
abstract: Adenohypophysis spindle cell oncocytoma (ASCO) is a rare tumor recently reported by Roncaroli et al in 2002. This tumor is considered a grade I tumor by the World Health Organization.We report a rare case of malignant ASCO with repeating recurrences and a high Ki-67 index-a challenging diagnosis guided by clinical presentations, radiological signs, and postoperative pathological tests.We represent a 30-year-old man who had suffered from headaches, diplopia, and impaired visual field and acuity. His magnetic resonance imaging revealed an abnormal sellar mass and was originally misdiagnosed as a pituitary macroadenoma. We present detailed analysis of the patient's disease course and review relevant literature.When surgically treated, the specimen revealed a typical histopathology pattern of ASCO. The tumor recurred for several times and the patient underwent 3 surgeries and 1 γ-knife treatment, which was accompanied by a continuously increasing Ki-67 index.This is the first reported case of malignant ASCO (WHO III-IV grade). Despite its rarity, ASCO should be considered in the differential diagnosis of sellar lesions that mimic pituitary adenomas.
authors.affiliation: Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Kong
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.forename: Yanguo
authors.initials: Y
authors.lastname: Kong
authors.forename: Dingrong
authors.initials: D
authors.lastname: Zhong
mesh_terms: D018249:Adenoma, Oxyphilic / Q000737:chemistry / Q000473:pathology*; D000328:Adult; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000737:chemistry / Q000473:pathology*; D010903:Pituitary Gland, Anterior / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D019394:Ki-67 Antigen