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DOI: 10.1055/s-0041-1731062
Huge Sellar Plasmacytoma as Differential Diagnosis of Invasive Pituitary Adenoma: A Case Report
Plasmocitoma selar enorme como diagnóstico diferencial de adenoma hipofisário invasivo: um relato de caso
Abstract
Sellar plasmacytomas are rare tumors arising from plasma cells. They are often misdiagnosed as adenomas. We report the case of a 63-year-old woman with headache, cranial nerve III palsy and decreased visual acuity. Imaging revealed an extensive lesion centered on the clivus, extending to the cavernous sinus bilaterally and into the sphenoid sinus. The hormonal tests were compatible with panhypopituitarism and mild hyperprolactinemia. The first hypothesis was invasive pituitary adenoma. Partial resection was achieved, and the immunohistochemical evaluation was compatible with plasmacytoma. After a few weeks, she developed lumbar and hip pain, and the imaging confirming osteolytic lesions. The final diagnosis was multiple myeloma.
Resumo
Plasmacitomas selares são tumores raros originados de células plasmáticas. Freqüentemente são diagnosticados erroneamente como adenomas. Relatamos o caso de uma mulher de 63 anos com cefaleia paralisia dos nervos cranianos III e diminuição da acuidade visual. A imagem revelou uma lesão extensa centrada no clivus estendendo-se para o seio cavernoso bilateralmente e para o seio esfenoidal. Os testes hormonais foram compatíveis com pan-hipopituitarismo e hiperprolactinemia leve. A primeira hipótese era adenoma hipofisário invasivo. Foi realizada ressecção parcial e a avaliação imunoistoquímica compatível com plasmocitoma. Após algumas semanas ela desenvolveu dor lombar e no quadril e a imagem confirmando lesões osteolíticas. O diagnóstico final foi mieloma múltiplo.
Publication History
Received: 06 July 2020
Accepted: 09 March 2021
Article published online:
03 August 2021
© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
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