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Invasive Pituitary Adenoma

Department of Endocrinology and Metabolism, Washington Hospital Center, Washington, D.C. 20010

Address all correspondence and requests for reprints to: Meeta Sharma, M.D., Department of Endocrinology and Metabolism, Washington Hospital Center, 110 Irving Street, NW, Washington, D.C. 20010. E-mail: Meeta.sharma{at}medstar.net.

A 24-yr-old male was admitted with headaches and recurrent syncope for 2 yr. Laboratory tests confirmed pan-hypopituitarism and diabetes insipidus requiring vasopressin, cortisol, and levothyroxine replacement. Brain magnetic resonance imaging showed a 10- x 6.8- x 6.6-cm tumor centered in the sella compressing the optic chiasm. Figure 1 is a contrast-enhanced T1-weighted coronal image showing a 5-cm exophytic component extending into the right lateral ventricle. Figure 2 is a sagittal view showing a 2.7-cm posterior component compressing the third ventricle and the aqueduct. The hydrocephalus was relieved by external ventricular drain placement followed by transfrontal partial tumor resection. Pathology showed a nonfunctioning pituitary adenoma with negative immunohistochemical stains. Pituitary adenomas are slow-growing tumors within the sella turcica. However, they may grow aggressively and are considered invasive when they infiltrate the dura mater, cranial bone, or sphenoid sinus. Invasive pituitary adenomas account for approximately 35% of all pituitary neoplasms, and treatment consists of surgery and radiotherapy (1).

View larger version (179K): [in this window] [in a new window]   FIG. 1. Contrast-enhanced T1-weighted coronal magnetic resonance imaging showing a 10- x 6.8- x 6.6-cm pituitary tumor with a 5-cm exophytic component extending into the right lateral ventricle.

View larger version (177K): [in this window] [in a new window]   FIG. 2. Sagittal view showing a 2.7-cm posterior component compressing the third ventricle and the aqueduct.

	Footnotes

 
Disclosure Statement: The authors have nothing to disclose.

Received May 20, 2008.

Accepted June 25, 2008.

	References

Top References

 

1. Scheithauer BW, Kovacs KT, Laws Jr ER, Randall RV 1986 Pathology of invasive pituitary tumors with special reference to functional classification. J Neurosurg 65:733–744[Medline]

This Article Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Li-Ng, M. Articles by Sharma, M. Search for Related Content PubMed PubMed Citation Articles by Li-Ng, M. Articles by Sharma, M. Related Collections Neuroendocrinology and Pituitary Endocrine Oncology