Cranial and Spinal Metastasis of a Nonfunctioning Pituitary Adenoma: Report of a Case

Abstract

Pituitary carcinoma is a rare disease with surgical, radiotherapeutic, and chemotherapeutic treatment options. We present the case of a female patient diagnosed with a nonfunctioning pituitary adenoma who underwent several surgical procedures, radiations, and chemotherapeutic treatments with various substances. Sixteen years after the first diagnosis, a cranial and spinal metastatic spread of the tumor occurred. We opted for an individual therapy based on anecdotal evidence. Unfortunately, the recommended off-label treatment with a somatostatin analog substance was never given due to bureaucratic delays. This case report is about the challenging aspects of individual decision-making in rare neurosurgical diseases.

Keywords

pituitary carcinoma - cranial and spinal metastasis - temozolomide - pasireotide

Publikationsverlauf

Eingereicht: 29. Oktober 2020

Angenommen: 23. April 2021

Artikel online veröffentlicht:
02. Dezember 2021

• References

• 1 World Health Organization. Who classification of tumours of the Central Nervous System. 4th ed.. Lyon: International Agency for Research on Cancer; 2016
• 2 Pernicone PJ, Scheithauer BW, Sebo TJ. et al. Pituitary carcinoma: a clinicopathologic study of 15 cases. Cancer 1997; 79 (04) 804-812
• 3 Raverot G, Burman P, McCormack A. et al; European Society of Endocrinology. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas. Eur J Endocrinol 2018; 178 (01) G1-G24
• 4 Bode H, Seiz M, Lammert A. et al. SOM230 (pasireotide) and temozolomide achieve sustained control of tumour progression and ACTH secretion in pituitary carcinoma with widespread metastases. Exp Clin Endocrinol Diabetes 2010; 118 (10) 760-763
• 5 Roncaroli F, Scheithauer BW, Horvath E. et al. Silent subtype 3 carcinoma of the pituitary: a case report. Neuropathol Appl Neurobiol 2010; 36 (01) 90-94
• 6 Dudziak K, Honegger J, Bornemann A, Horger M, Müssig K. Pituitary carcinoma with malignant growth from first presentation and fulminant clinical course: case report and review of the literature. J Clin Endocrinol Metab 2011; 96 (09) 2665-2669
• 7 Ragel BT, Couldwell WT. Pituitary carcinoma: a review of the literature. Neurosurg Focus 2004; 16 (04) E7
• 8 Lopes MBS, Scheithauer BW, Schiff D. Pituitary carcinoma: diagnosis and treatment. Endocrine 2005; 28 (01) 115-121
• 9 van der Vlist A, Snijders TJ, Stades AME, Spliet WGM, De Vos FYFL. Successful treatment of leptomeningeally metastasised pituitary carcinoma with temozolomide. Neth J Med 2017; 75 (10) 451-454
• 10 Bruno OD, Juárez-Allen L, Christiansen SB. et al. Temozolomide therapy for aggressive pituitary tumors: results in a small series of patients from Argentina. Int J Endocrinol 2015; 2015: 587893
• 11 Koyama J, Ikeda K, Shose Y, Kimura M, Obora Y, Kohmura E. Long-term survival with non-functioning pituitary carcinoma: case report. Neurol Med Chir (Tokyo) 2007; 47 (10) 475-478
• 12 Sakamoto T, Itoh Y, Fushimi S, Kowada M, Saito M. Primary pituitary carcinoma with spinal cord metastasis: case report. Neurol Med Chir (Tokyo) 1990; 30 (10) 763-767