Seeding of Pituitary Carcinoma Throughout the Neuraxis: Lessons from an Interesting Case

Abstract

Masoud Shirvani, Mohammadali Arami, Behrang Kazeminezhad and Zeynab Kishani Farahani

Background: Pituitary neuroendocrine tumors are predominantly benign, although a minority may exhibit invasive tendencies. Only a small percentage of pituitary tumors show evidence of neuraxis seeding. Assessing the risk of spread and metastasis is crucial for timely diagnosis and effective treatment in these cases.

Case Description: This article presents a case of pituitary carcinoma diagnosed four years apart, following two surgeries for pituitary macroadenoma, and subsequent spread throughout the spinal canal. A third surgery was performed to address lumbosacral metastasis, and histopathological findings, including immunohistochemistry studies, confirmed the diagnosis of metastatic pituitary carcinoma.

Conclusions: This case can contribute to refining future clinically relevant definitions of the disease. Additionally, predicting aggressiveness and the potential for malignant transformation using clinical, imaging, histopathological, and moleculargenetic criteria is essential for managing these tumors.

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