Endocrine Abstracts

We report the case of a 49 y.o male with an incidental sphenoidal-sellar tumour discovered during a cerebral CT scan during the workup of a medium to severe SARS COV 2 infection. The cerebral MRI describes an invasive tumour located in the sellar region and sphenoidal sinus – extended around the right optic nerve and into both cavernous sinuses. An emergency biopsy from the sphenoidal extension of the tumour revealed a neuroendocrine tumour. The reported diagnostic was olfactory neuroblastoma grade I Hyams (positive stains for synaptophysin, NSE, Ki67 index of 8%). The patient was referred to a mixt expertise surgical team (ENT- neurosurgery). He undergoes removal of the sphenoidal- sellar tumour – 5 weeks from the diagnostic. His first endocrine evaluation was following surgery due to the development of central hypocortisolism, and replacement therapy was started. He undergoes radiotherapy for residual tumour two months after surgery. The initial anatomopathological report from the surgical sample described an olfactory neuroblastoma grade I Hyams (Ki67 index 1%). Reconsideration of immunohistochemistry from the tumour sample stains positive for SF1, GATA3, LH and FSH with a Ki67 index of 1%, and a diagnostic of invasive gonadotropinoma was concluded. We assume the systemic inflammatory status during SAR COV2 infection is responsible for the difference in the Ki67 index counted five weeks apart from the biopsy sample and the tumour sample during surgery.