ACTH‐secreting Crooke cell carcinoma of the pituitary. (7th November 2012)

• Record Type: Journal Article
• Authors: Kovács, Gábor L.; Góth, Miklós; Rotondo, Fabio; Scheithauer, Bernd W.; Carlsen, Eivind; Saadia, Ali; Hubina, Erika; Kovács, László; Szabolcs, István; Nagy, Pál; Czirják, Sándor; Hanzély, Zoltán; Kovács, Kálmán; Horváth, Éva; Korbonits, Márta
• Is Part Of: European journal of clinical investigation. Volume 43:Number 1(2013:Jan.)
• Page Start: 20
• Page End: 26
• Publication Date: 2012-11-07
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12010
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="sec-sum-1" sec-type="section"> <p>Eur J Clin Invest 2012</p> </sec> <sec id="abs1-1" sec-type="section"> <title>Abstract</title> <p> <bold>Purpose </bold> While pituitary adenomas are common, pituitary carcinomas are rare. It is unclear whether pituitary carcinomas arise <italic>de novo</italic> or evolve from adenomas.</p> <p> <bold>Methods </bold> We studied the clinical characteristics and tissue samples from eight pituitary surgeries and the autopsy from a patient with pituitary carcinoma. A 16‐year‐old female patient was diagnosed with an aggressive Crooke cell macroadenoma. Following transsphenoidal surgery, clinical signs of Cushing disease quickly reappeared. During the 14‐year course of the illness, eight pituitary surgeries, three courses of extracranial irradiation and two <sup>90</sup>Yttrium‐DOTATOC treatments were undertaken. A bilateral adrenalectomy was performed. The patient died of metastatic disease and uncontrolled hypercortisolism due to an adrenal remnant. A systematic morphologic study (histologic staining, electron microscopy) of all available surgical and autopsy specimens was undertaken.</p> <p> <bold>Results </bold> Brisk mitotic activity, high Ki‐67 and p53 immunolabelling were present in the pituitary samples from the onset. High proportion of tumour cells showed irregular nuclei and large nucleoli, and gradual increase in MGMT staining was observed. The tumour remained of Crooke cell type throughout the course. Autopsy disclosed a postirradiation sarcoma in the pituitary area.</p> <p> <bold>Conclusions </bold> The question whether pituitary carcinomas arise <italic>de novo</italic> or transform from an adenoma cannot be answered at present with certainty.</p> </sec> </abstract>