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Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature Review.
Neurosurgery. 2002 Mar; 50(3):618-25.N

Abstract

OBJECTIVE AND IMPORTANCE

Functional ectopic pituitary adenomas are rare and can be misdiagnosed as extensions of pituitary adenomas when they are located in the vicinity of the normal gland. In this report, we present a case of an ectopic adrenocorticotropic hormone-secreting suprasellar pituitary adenoma that caused Cushing's disease. A literature review of previously reported ectopic pituitary adenomas is included to illustrate the diverse clinical manifestations of this disease entity.

CLINICAL PRESENTATION

An 11-year-old boy was noted to have hirsutism, a buffalo hump, and unexplained weight gain consistent with Cushing's syndrome. Laboratory investigations revealed that the boy had elevated adrenocorticotropic hormone and serum cortisol levels unsuppressed by dexamethasone. Magnetic resonance imaging scans were suggestive of a pituitary adenoma with suprasellar extension.

INTERVENTION

The initial transsphenoidal approach failed to achieve complete surgical resection. A repeat operation in which the pterional approach was used revealed a suprasellar pituitary adenoma without association with intrasellar contents. The patient's cushingoid symptoms improved significantly 3 months after surgery.

CONCLUSION

Ectopic pituitary adenomas should be considered in the differential diagnosis for all patients with Cushing's syndrome. Furthermore, surgical approaches should be chosen carefully once the diagnosis of ectopic pituitary adenoma is made.

Authors+Show Affiliations

Department of Neurosurgery, Stanford University School of Medicine, Stanford, California 94305, USA. VKT@stanford.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

11841732

Citation

Hou, Lewis, et al. "Suprasellar Adrenocorticotropic Hormone-secreting Ectopic Pituitary Adenoma: Case Report and Literature Review." Neurosurgery, vol. 50, no. 3, 2002, pp. 618-25.
Hou L, Harshbarger T, Herrick MK, et al. Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature Review. Neurosurgery. 2002;50(3):618-25.
Hou, L., Harshbarger, T., Herrick, M. K., & Tse, V. (2002). Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature Review. Neurosurgery, 50(3), 618-25.
Hou L, et al. Suprasellar Adrenocorticotropic Hormone-secreting Ectopic Pituitary Adenoma: Case Report and Literature Review. Neurosurgery. 2002;50(3):618-25. PubMed PMID: 11841732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature Review. AU - Hou,Lewis, AU - Harshbarger,Todd, AU - Herrick,Maie K, AU - Tse,Victor, PY - 2002/2/14/pubmed PY - 2002/4/6/medline PY - 2002/2/14/entrez SP - 618 EP - 25 JF - Neurosurgery JO - Neurosurgery VL - 50 IS - 3 N2 - OBJECTIVE AND IMPORTANCE: Functional ectopic pituitary adenomas are rare and can be misdiagnosed as extensions of pituitary adenomas when they are located in the vicinity of the normal gland. In this report, we present a case of an ectopic adrenocorticotropic hormone-secreting suprasellar pituitary adenoma that caused Cushing's disease. A literature review of previously reported ectopic pituitary adenomas is included to illustrate the diverse clinical manifestations of this disease entity. CLINICAL PRESENTATION: An 11-year-old boy was noted to have hirsutism, a buffalo hump, and unexplained weight gain consistent with Cushing's syndrome. Laboratory investigations revealed that the boy had elevated adrenocorticotropic hormone and serum cortisol levels unsuppressed by dexamethasone. Magnetic resonance imaging scans were suggestive of a pituitary adenoma with suprasellar extension. INTERVENTION: The initial transsphenoidal approach failed to achieve complete surgical resection. A repeat operation in which the pterional approach was used revealed a suprasellar pituitary adenoma without association with intrasellar contents. The patient's cushingoid symptoms improved significantly 3 months after surgery. CONCLUSION: Ectopic pituitary adenomas should be considered in the differential diagnosis for all patients with Cushing's syndrome. Furthermore, surgical approaches should be chosen carefully once the diagnosis of ectopic pituitary adenoma is made. SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/11841732/Suprasellar_adrenocorticotropic_hormone_secreting_ectopic_pituitary_adenoma:_case_report_and_literature_Review_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1097/00006123-200203000-00035 DB - PRIME DP - Unbound Medicine ER -