A Case of Atypical Thyrotroph Cell Adenoma, Which Re-grew Within 3 Months After Surgery and Required Multimodal Treatment

Overview

Journal J Neurooncol

Publisher Springer

Date 2007 Nov 8

PMID 17987261

Citations 8

Authors

Yoshikazu Ogawa

Teiji Tominaga

Affiliations

Soon will be listed here.

Abstract

Objective And Importance: Thyrotroph cell adenoma accounts for only 1% of all pituitary adenomas. This tumor is tough and firm because of significant interstitial fibrosis, and is difficult to remove. Atypical adenoma has an aggressive biological character, invades the surrounding structures, and grows rapidly. Atypical thyrotroph cell adenoma is extremely rare.

Clinical Presentation: A 32-year-old man presented with hyperthyroidism and bitemporal hemianopsia. Head magnetic resonance imaging revealed a large sellar tumor compressing the optic chiasma and invading the left cavernous sinus.

Intervention: Transsphenoidal surgery was performed and subtotal removal was achieved. Histological examination showed atypical thyrotroph cell adenoma. Gamma knife surgery was planned, but the tumor re-grew within 3 months, and reattached to the optic chiasma. Second transcranial surgery failed to remove residual tumor behind the pituitary stalk. Conventional irradiation followed by octreotide administration resulted in decreased tumor size and stable euthyroidism. The tumor has been controlled for 22 months since first surgery and diagnosis.

Conclusion: Atypical thyrotroph cell adenoma has an aggressive biological character and grows rapidly. Multimodal treatment including medication and radiotherapy is required.

Citing Articles

A Collision Tumor of Pit-1/SF-1-positive Double Pituitary Adenoma and a Craniopharyngioma Coexisting with Graves' Disease.

Kikuta H, Jinguji S, Sato T, Bakhit M, Hiruta R, Sato Y NMC Case Rep J. 2023; 10:169-175.

PMID: 37398916 PMC: 10310352. DOI: 10.2176/jns-nmc.2022-0396.

Case report of recurrent atrial fibrillation induced by thyrotropin-secreting pituitary adenoma with Graves' disease.

Li J, Tan H, Huang J, Luo D, Tang Y, Yu R Medicine (Baltimore). 2018; 97(24):e11047.

PMID: 29901603 PMC: 6023673. DOI: 10.1097/MD.0000000000011047.

Mid-term prognosis of non-functioning pituitary adenomas with high proliferative potential: really an aggressive variant?.

Ogawa Y, Jokura H, Niizuma K, Tominaga T J Neurooncol. 2018; 137(3):543-549.

PMID: 29318507 DOI: 10.1007/s11060-017-2740-1.

Thyrotropin-producing pituitary adenoma simultaneously existing with Graves' disease: a case report.

Arai N, Inaba M, Ichijyo T, Kagami H, Mine Y J Med Case Rep. 2017; 11(1):9.

PMID: 28061802 PMC: 5217335. DOI: 10.1186/s13256-016-1172-4.

Atypical pituitary adenomas: clinical characteristics and role of ki-67 and p53 in prognostic and therapeutic evaluation. A series of 50 patients.

Del Basso De Caro M, Solari D, Pagliuca F, Villa A, Guadagno E, Cavallo L Neurosurg Rev. 2016; 40(1):105-114.

PMID: 27215912 DOI: 10.1007/s10143-016-0740-9.

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