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Ectopic pituitary adenomas: common presentations of a rare entity

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Abstract

Purpose

Ectopic pituitary adenomas (EPA) are rare tumors thought to arise from embryological remnants along the route of normal pituitary migration. Clinically, these tumors vary in hormonal activity and can exert mass effect based on location and size.

Methods

We performed a single-center retrospective analysis of patients with diagnosis of ectopic pituitary adenoma from 2001 to 2018.

Results

Five patients were identified with EPA: a 48-year-old woman with suprasellar EPA treated with transsphenoidal removal of the tumor, a 44-year-old woman with cavernous EPA treated with transsphenoidal removal of the tumor, a 48-year-old woman with sphenoid EPA treated with cabergoline, a 45-year-old man with clival EPA treated with cabergoline and transsphenoidal surgical resection, and a 54-year-old man with clival EPA treated with cabergoline therapy.

Conclusions

EPA should be considered as a differential diagnosis of juxta-sellar lesions. Appropriate hormonal testing may lead to early diagnosis, avoidance of unnecessary biopsy or surgery, and improved outcomes.

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References

  1. Nakane PK (1970) Classifications of anterior pituitary cell types with immunoenzyme histochemistry. J Histochem Cytochem 18(1):9–20. https://doi.org/10.1177/18.1.9

    Article  CAS  PubMed  Google Scholar 

  2. ElSayed SA, Bhimji SS (2018) Physiology, Pituitary Gland. StatPearls Publishing LLC, Treasure Island

    Google Scholar 

  3. Ilahi S, Ilahi TB (2018) Anatomy, Adenohypophysis (Pars Anterior, Anterior Pituitary). StatPearls Publishing LLC, Treasure Island

    Google Scholar 

  4. Stopa EG, LeBlanc VK, Hill DH, Anthony EL (1993) A general overview of the anatomy of the neurohypophysis. Ann N Y Acad Sci 689:6–15

    Article  CAS  PubMed  Google Scholar 

  5. Amar AP, Weiss MH (2003) Pituitary anatomy and physiology. Neurosurg Clin N Am 14(1):11–23 v

    Article  PubMed  Google Scholar 

  6. Larkin S, Ansorge O (2017) Development and microscopic anatomy of the pituitary gland. Endotext. https://www.endotext.org. Accessed 1 Feb 2019

  7. Dorton AM (2000) The pituitary gland: embryology, physiology, and pathophysiology. Neonatal Netw 19(2):9–17. https://doi.org/10.1891/0730-0832.19.2.9

    Article  CAS  PubMed  Google Scholar 

  8. Patel H, Tiwari V (2018) Physiology, Posterior Pituitary. StatPearls Publishing LLC, Treasure Island

    Google Scholar 

  9. Ciocca DR, Puy LA, Stati AO (1985) Identification of seven hormone-producing cell types in the human pharyngeal hypophysis. J Clin Endocrinol Metab 60(1):212–216. https://doi.org/10.1210/jcem-60-1-212

    Article  CAS  PubMed  Google Scholar 

  10. Melchionna RH, Moore RA (1938) The pharyngeal pituitary gland. Am J Pathol 14(6):763–772 761

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Hou L, Harshbarger T, Herrick MK, Tse V (2002) Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature review. Neurosurgery 50(3):618–625

    PubMed  Google Scholar 

  12. Hori A (1985) Suprasellar peri-infundibular ectopic adenohypophysis in fetal and adult brains. J Neurosurg 63(1):113–115. https://doi.org/10.3171/jns.1985.63.1.0113

    Article  CAS  PubMed  Google Scholar 

  13. Rasmussen P, Lindholm J (1979) Ectopic pituitary adenomas. Clin Endocrinol (Oxf) 11(1):69–74

    Article  CAS  Google Scholar 

  14. Ortiz-Suarez H, Erickson DL (1975) Pituitary adenomas of adolescents. J Neurosurg 43(4):437–439. https://doi.org/10.3171/jns.1975.43.4.0437

    Article  CAS  PubMed  Google Scholar 

  15. Kleinschmidt-DeMasters BK, Winston KR, Rubinstein D, Samuels MH (1990) Ectopic pituitary adenoma of the third ventricle. Case report. J Neurosurg 72(1):139–142. https://doi.org/10.3171/jns.1990.72.1.0139

    Article  CAS  PubMed  Google Scholar 

  16. Neilson K, de Chadarevian JP (1987) Ectopic anterior pituitary corticotropic tumour in a six-year-old boy. Histological, ultrastructural and immunocytochemical study. Virchows Arch A Pathol Anat Histopathol 411(3):267–273

    Article  CAS  PubMed  Google Scholar 

  17. Yang BT, Chong VF, Wang ZC, **an JF, Chen QH (2010) Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings. Br J Radiol 83(987):218–224. https://doi.org/10.1259/bjr/76663418

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Thompson LD, Seethala RR, Muller S (2012) Ectopic sphenoid sinus pituitary adenoma (ESSPA) with normal anterior pituitary gland: a clinicopathologic and immunophenotypic study of 32 cases with a comprehensive review of the english literature. Head Neck Pathol 6(1):75–100. https://doi.org/10.1007/s12105-012-0336-9

    Article  PubMed  PubMed Central  Google Scholar 

  19. Langford L, Batsakis JG (1995) Pituitary gland involvement of the sinonasal tract. Ann Otol Rhinol Laryngol 104(2):167–169. https://doi.org/10.1177/000348949510400217

    Article  CAS  PubMed  Google Scholar 

  20. Mason RB, Nieman LK, Doppman JL, Oldfield EH (1997) Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function. J Neurosurg 87(3):343–351. https://doi.org/10.3171/jns.1997.87.3.0343

    Article  CAS  PubMed  Google Scholar 

  21. Guerrero CA, Krayenbuhl N, Husain M, Krisht AF (2007) Ectopic suprasellar growth hormone-secreting pituitary adenoma: case report. Neurosurgery 61(4):E879; (discussion E879). https://doi.org/10.1227/01.neu.0000298921.47495.42

    Article  PubMed  Google Scholar 

  22. Warner BA, Santen RJ, Page RB (1982) Growth hormone and prolactin secretion by a tumor of the pharyngeal pituitary. Ann Intern Med 96(1):65–66. https://doi.org/10.7326/0003-4819-96-1-65

    Article  CAS  PubMed  Google Scholar 

  23. Pugnale N, Waridel F, Bouzourene H, Boubaker A, Pugnale M, Gaillard RC, Gomez F (2003) Pharyngeal pituitary non-functioning adenoma with normal intra-sellar gland: massive tumor shrinkage on octreotide therapy. Eur J Endocrinol 148(3):357–364

    Article  CAS  PubMed  Google Scholar 

  24. Karras CL, Abecassis IJ, Abecassis ZA, Adel JG, Bit-Ivan EN, Chandra RK, Bendok BR (2016) Clival ectopic pituitary adenoma mimicking a Chordoma: case report and review of the literature. Case Rep Neurol Med. https://doi.org/10.1155/2016/8371697

    Article  PubMed  PubMed Central  Google Scholar 

  25. Narese D, Virzi V, Virzi G, Narese F, Sciortino A, Culmone G, Virzi F, Maira G (2015) Ectopic prolactinoma in the clivus: a case report. La Clin Ter 166(4):176–178. https://doi.org/10.7417/ct.2015.1866

    Article  CAS  Google Scholar 

  26. Sakakibara Y, Sekino H, Taguchi Y, Tadokoro M (2002) Unilateral exophthalmos caused by a prolactin producing ectopic pituitary adenoma: case report. No Shinkei Geka Neurol surg 30(6):623–628

    Google Scholar 

  27. Hanaoka Y, Ogiwara T, Kakizawa Y, Nagm A, Seguchi T, Aoyama T, Koyama J-i, Sato A, Hongo K (2018) Calcified ectopic TSH-secreting pituitary adenoma mimicking craniopharyngioma: a rare case report and literature review. Acta Neurochir 160(10):2001–2005. https://doi.org/10.1007/s00701-018-3638-1

    Article  PubMed  Google Scholar 

  28. Ballaux D, Verhelst J, Pickut B, De Deyn PP, Mahler C (1999) Ectopic macroprolactinoma mimicking a chordoma: a case report. Endocr Relat Cancer 6(1):117–122

    Article  CAS  PubMed  Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or non-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA

    Ali Agely, Lela Okromelidze, Erik H. Middlebrooks & Vivek Gupta

  2. Department of Neurology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA

    George K. Vilanilam

  3. Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA

    Kaisorn L. Chaichana, Erik H. Middlebrooks & Vivek Gupta

  4. Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32082, USA

    Vivek Gupta

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  1. Ali Agely
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  2. Lela Okromelidze
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Correspondence to Vivek Gupta.

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Agely, A., Okromelidze, L., Vilanilam, G.K. et al. Ectopic pituitary adenomas: common presentations of a rare entity. Pituitary 22, 339–343 (2019). https://doi.org/10.1007/s11102-019-00954-y

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