Abstract | OBJECTIVE: METHODS: RESULTS: A 64-year-old woman presented with sudden onset of ophthalmoplegia. Magnetic resonance imaging (MRI) scan showed a pituitary macroadenoma (2.2 x 2.1 cm) with invasion of the right cavernous sinus. Biochemical data was consistent with a nonfunctioning pituitary adenoma. Pathology showed a pituitary adenoma with negative immunohistochemistry for pituitary hormones. The patient returned a month later with weakness, lethargy, and a dilated nonreactive right pupil. MRI showed an invasive large mass (5 x 4.7 cm). After an emergent second transsphenoidal surgery, histopathologic examination revealed a widely infiltrative neoplasm invading the overlying mucosa and showing a high mitotic activity and necrosis and a very high Ki-67 (MIB-1) proliferation index (80%). MIB-1 retrospectively performed on the first specimen was also elevated (30%). Soon after the second surgery, MRI showed a 7.9 x 8.0 cm mass that metastasized to dura mater and extended into the right orbit, right middle cranial fossa, nasopharynx, clivus, posterior fossa, and along the right tentorium cerebelli, resulting in significant compression of the brainstem. CONCLUSION:
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Authors | Francisco J Pasquel, Cristina Vincentelli, Daniel J Brat, Nelson M Oyesiku, Adriana G Ioachimescu |
Journal | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
(Endocr Pract)
2013 May-Jun
Vol. 19
Issue 3
Pg. e69-73
ISSN: 1934-2403 [Electronic] United States |
PMID | 23425649
(Publication Type: Case Reports, Journal Article)
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Topics |
- Carcinoma
(diagnosis)
- Female
- Humans
- Magnetic Resonance Imaging
- Middle Aged
- Pituitary Neoplasms
(diagnosis)
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