Malignant adenohypophysis spindle cell oncocytoma with repeating recurrences and a high Ki-67 index. Issue 4 (January 2017)

• Record Type: Journal Article
• Authors: Kong, Xiangyi; Li, Dongmei; Kong, Yanguo; Zhong, Dingrong
• Other Names: Dora. Zelena section editor.
• Is Part Of: Medicine. Volume 96:Issue 4(2017)
• Publication Date: 2017-01
• Subjects: adenohypophysis spindle cell oncocytoma -- Ki-67 index -- malignant -- recurrent; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000005657
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Adenohypophysis spindle cell oncocytoma (ASCO) is a rare tumor recently reported by Roncaroli et al in 2002. This tumor is considered a grade I tumor by the World Health Organization. We report a rare case of malignant ASCO with repeating recurrences and a high Ki-67 index—a challenging diagnosis guided by clinical presentations, radiological signs, and postoperative pathological tests. We represent a 30-year-old man who had suffered from headaches, diplopia, and impaired visual field and acuity. His magnetic resonance imaging revealed an abnormal sellar mass and was originally misdiagnosed as a pituitary macroadenoma. We present detailed analysis of the patient's disease course and review relevant literature. When surgically treated, the specimen revealed a typical histopathology pattern of ASCO. The tumor recurred for several times and the patient underwent 3 surgeries and 1 γ-knife treatment, which was accompanied by a continuously increasing Ki-67 index. This is the first reported case of malignant ASCO (WHO III–IV grade). Despite its rarity, ASCO should be considered in the differential diagnosis of sellar lesions that mimic pituitary adenomas.