Endocrine Abstracts (2008) 16 P412

A non-functioning pituitary carcinoma with cerebellar metastases

Inmaculada Gavilán1, José Ortego1, Cristina Coserria1, José Gil2, Ana Rodríguez3, Miguel Japón4 & Manuel Aguilar1


1Department of Endocrinology, Puerta del Mar Hospital, Cádiz, Spain; 2Department of Neurosurgery, Puerta del Mar Hospital, Cádiz, Spain; 3Department of Radiology, Puerta del Mar Hospital, Cádiz, Spain; 4Department of Pathology, Virgen del Rocío Hospital, Sevilla, Spain.


Pituitary carcinomas are rare but represent a particular challenge to clinical practice. We report a case of pituitary carcinoma with metastatic disease in a separate non-contiguous foci within the central nervous system. A 64 year old man presented with a large non-functioning pituitary adenoma manifesting as headache, third pair of cranial nerves paralysis, panhypopituitarism and impaired visual acuity in 1996.The tumour was grossly removed through a right pterional craniotomy. Conventional radiotherapy for the residual tumour was performed in 1997. Follow-up magnetic resonance (MR) imaging revealed a residual tumour close to the left cavernous sinus and in the posterior sellar region. New signs of mass effect with headache, ataxia and dismetria developed in 2006. A MR showed a tumour located in the cerebellar vermis, which was excised by suboccipital craniotomy. Histological examination of the specimen revealed typical pituitary adenoma. The post-surgical MR revealed only a residual tumour in the sellar region. Other studies including chest radiography, abdominal ultrasound, vertebral column MR, octreoscan and positron emission tomography (PET) did not show any other metastases. Conclusions: this case documents an 11 year history of a rare non-functioning pituitary carcinoma which metastasized in cerebellum and shows that pituitary carcinomas may present as typical pituitary adenomas which may reveal their malignant character with distant metastases only as time progresses. Distant lesions should be removed for histological evaluation to plan the subsequent management.

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