ACTH-producing pituitary carcinoma presenting as the cauda equina syndrome.

Abstract

A 43-year-old woman presented with incontinence, weakness, and paresthesia, consistent with the cauda equina syndrome, 10 years after having a pituitary tumor surgically removed and 4 years after excision of two "meningiomas" of the cervical cord. The patient was also hypertensive and had a cushingoid habitus. Emergent surgical decompression of the spinal cord revealed intradural metastatic adrenocorticotropic hormone-producing pituitary carcinoma. Pituitary carcinomas are rare. The majority of reported cases of adrenocorticotropic hormone-producing carcinoma have exhibited metastases outside the central nervous system. To our knowledge, this represents the first case of an adrenocorticotropic hormone-producing pituitary carcinoma presenting with the cauda equina syndrome. A review of all reported cases of pituitary carcinoma indicated that central nervous system metastases were more common than metastases to distant sites, and patients with distant metastases experienced a shorter duration of disease than did those with central nervous system metastases.

• Authors: A R Frost, S Tenner, M Tenner, C Rollhauser, S O Tabbara
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 119 Issue 1 Pg. 93-6 (Jan 1995) ISSN: 0003-9985 [Print] United States
• PMID: 7802565 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Adrenocorticotropic Hormone

Topics

• Adrenocorticotropic Hormone (biosynthesis)
• Adult
• Cauda Equina
• Cushing Syndrome (etiology)
• Diagnosis, Differential
• Female
• Humans
• Nerve Compression Syndromes (etiology)
• Pituitary Neoplasms (blood, complications, diagnosis, pathology)
• Spinal Cord Neoplasms (blood, complications, secondary)