Unusual case of metastatic neuroendocrine tumor.

Abstract

OBJECTIVE:

To report a rare case of metastatic growth hormone (GH)-secreting pituitary carcinoma causing acromegaly.

METHODS:

We present a case report and review the available literature on this topic.

RESULTS:

A 68-year-old woman presented with persistent acromegaly after treatment for a GH-secreting pituitary adenoma. Evaluation of long-standing cervical adenopathy revealed findings consistent with a metastatic neuroendocrine tumor. Further work-up revealed additional thyroid, parathyroid, and cervical masses. After operative treatment including total thyroidectomy, subtotal parathyroidectomy, partial thymectomy, and right modified radical neck dissection, the patient's symptoms diminished, and her GH levels approached the normal range. Surgical pathology findings were consistent with a GH-secreting pituitary carcinoma metastatic to the cervical lymph nodes, multinodular thyroid hyperplasia with a focus of papillary microcarcinoma, and parathyroid hyperplasia.

CONCLUSION:

Overall, pituitary carcinomas are extremely rare. To date, about 100 cases have been reported in the world's literature, and of these, only 19 cases originated from GH-secreting cells. Our examination of the symptoms, signs, diagnosis, and treatment of our patient, in comparison with the previously reported cases, should enhance awareness of this unusual disease process.

• Authors: Michele A Manahan, Alan P B Dackiw, Douglas W Ball, Martha A Zeiger
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) 2007 Jan-Feb Vol. 13 Issue 1 Pg. 72-6 ISSN: 1934-2403 [Electronic] United States
• PMID: 17360306 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Acromegaly (etiology)
• Adenoma (complications, pathology, surgery)
• Aged
• Female
• Growth Hormone-Secreting Pituitary Adenoma (complications, pathology, surgery)
• Humans
• Lymphatic Metastasis
• Parathyroid Neoplasms (complications, secondary, surgery)
• Thymus Neoplasms (complications, secondary, surgery)
• Thyroid Neoplasms (complications, secondary, surgery)