Intracranial and spinal dissemination of an ACTH secreting pituitary neoplasia. Case report and review of the literature

Salvatore Maria Corsello, Cesare Colosimo, Silvia Della Casa, Maria Antonia Satta, Carlo Antonio Rota, Carmelo Anile, Antonino Barbarino, P Putignano, V Vangeli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

15 Citazioni (Scopus)

Abstract

We report a case of a 52-year-old woman presenting with a recurrence of a large pituitary adenoma with suprasellar extension and an overt Cushing's clinical picture, five years after successful transsphenoidal treatment. After transfrontal ablation of the tumour, followed by external radiotherapy, she was asymptomatic for six years before she exhibited epileptic seizures. A left frontal intracranial neoplasm was diagnosed and removed, and at histological examination it was found to be constituted by a localization of the pituitary ACTH secreting neoplasia. One month later she exhibited spinal dissemination of the ACTH secreting neoplasia which was only partially removed. After four months a Magnetic Resonance Image (MRI) revealed recurrence of the intracranial localization and further spinal dissemination. Because of compressive symptoms, spinal masses with the same histologic features, were partially removed again in three successive surgical operations. Several medical treatments for obtaining the control of corticoid excess, caused by the ACTH overproduction, were tried, but none were satisfactory. Finally a bilateral adrenal venous embolization was performed thus obtaining a critical transient fall of serum cortisol. Five months later the patient died. At necroscopy bilateral adrenal enlargement was found, spinal disseminations were confirmed, and no metastatic lesions were discovered.
Lingua originaleEnglish
pagine (da-a)503-509
Numero di pagine7
RivistaAnnales d'Endocrinologie
Volume58
Stato di pubblicazionePubblicato - 1997

Keywords

  • Adenoma
  • Adrenocorticotropic Hormone
  • Brain Neoplasms
  • Cushing Syndrome
  • Fatal Outcome
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pituitary Neoplasms
  • Reoperation
  • Spinal Cord Neoplasms

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