Extremely late development of pituitary carcinoma after surgery and radiotherapy

  • Eberval Gadelha Figueiredo
  • Wellingson Silva Paiva
  • Manoel Jacobsen Teixeira
Case Report


Introduction Pituitary carcinomas account for 0.1 or 0.2% of pituitary tumors. The authors report a rare case of a pituitary carcinoma mimicking a radio-induced meningioma. Case report Fifty-five years-old male presents a previous history of transcranial surgery in 1983 for invasive pituitary adenoma followed by whole-brain radiotherapy (5100 cGy). After three years he presented worsening of visual deficits and MRI evidenced recurrence of the lesion. In 1992, he underwent a transcranial approach to treat recurrent supraselar disease, followed by stereoctatic radiotherapy. In 2006, clinical condition was stable; however three right frontal extra-axial lesions were diagnosed by MRI, compatible with meningioma. The histological examination revealed pituitary adenoma. No lesions were found in craniospinal axis. Further treatment was not recommended by radiotherapists due previous actinic treatments. Two years radiological follow-up revealed no recurrence. Conclusion In these high risk cases, active and constant surveillance must be pertained, regardless the time of follow-up.


Pituitary adenoma Pituitary carcinoma Brain neoplasm Meningioma 


  1. 1.
    Brada M, Ford D, Ashley S et al (1992) Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. BMJ 304:1343–1346PubMedGoogle Scholar
  2. 2.
    Gaffey TA, Scheithauer BW, Lloyd RV et al (2002) Corticotroph carcinoma of the pituitary: a clinicopathological study. Report of four cases. J Neurosurg 96:352–360PubMedGoogle Scholar
  3. 3.
    Lormeau B, Miossec P, Sibony M et al (1997) Adrenocorticotropin producing pituitary carcinoma with liver metastasis. J Endocrinol Invest 20:230–236PubMedGoogle Scholar
  4. 4.
    Matsuki M, Kaji Y, Matsuo M et al (2000) MR findings of subarachnoid dissemination of a pituitary adenoma. Br J Radiol 73:783–785PubMedGoogle Scholar
  5. 5.
    McCutcheon IE, Pieper DR, Fuller GN et al (2000) Pituitary carcinoma containing gonadotropins: treatment by radical excision and cytotoxic chemotherapy: case report. Neurosurgery 46:1233–1240. doi: 10.1097/00006123-200005000-00042 PubMedCrossRefGoogle Scholar
  6. 6.
    Mixson AJ, Friedman TC, Katz DA et al (1993) Thyrotropin-secreting pituitary carcinoma. J Clin Endocrinol Metab 76:529–533. doi: 10.1210/jc.76.2.529 PubMedCrossRefGoogle Scholar
  7. 7.
    Pernicone PJ, Scheithauer BW (2001) Invasive pituitary adenoma and pituitary carcinoma. In: Thapar K, Kovacs K, Scheithauer BW et al (eds) Diagnosis and management of pituitary tumors. Humana Press, Totowa, NJ, pp 369–386Google Scholar
  8. 8.
    Pernicone PJ, Scheithauer BW, Sebo TJ et al (1997) Pituitary carcinoma: a clinicopathologic study of 15 cases. Cancer 79:804–812. doi:10.1002/(SICI)1097-0142(19970215)79:4<804::AID-CNCR18>3.0.CO;2-3PubMedCrossRefGoogle Scholar
  9. 9.
    Pei L, Melmed S, Scheithauer B et al (1994) H-ras mutations in human pituitary carcinoma metastases. J Clin Endocrinol Metab 78:842–846. doi: 10.1210/jc.78.4.842 PubMedCrossRefGoogle Scholar
  10. 10.
    Pichard C, Gerber S, Laloi M et al (2002) Pituitary carcinoma: report of an exceptional case and review of the literature. J Endocrinol Invest 25:65–72PubMedGoogle Scholar
  11. 11.
    Ragel BT, Couldwell WT (2004) Pituitary carcinoma: a review of the literature. Neurosurg Focus 16(4):E7. doi: 10.3171/foc.2004.16.4.8 PubMedCrossRefGoogle Scholar
  12. 12.
    Roncarolli F, Nose V, Scheithauer BW et al (2003) Gonadotropic pituitary carcinoma: HER-2/neu expression and gene amplification. Report of two cases. J Neurosurg 99:402–408CrossRefGoogle Scholar
  13. 13.
    Thapar K, Scheithnauer BW, Kovacs K et al (1996) p 53 expression in pituitary adenomas and carcinomas: correlation with invasiveness and tumor growth fractions. Neurosurgery 38:763–771. doi: 10.1097/00006123-199601000-00024 CrossRefGoogle Scholar
  14. 14.
    Vaquero J, Herrero J, Cincu R (2003) Late development of frontal prolactinoma after resection of pituitary tumor. J Neurooncol 64:255–258. doi: 10.1023/A:1025672617249 PubMedCrossRefGoogle Scholar
  15. 15.
    Zafar MS, Mellinger RC, Chason JL (1984) Cushing’s disease due to pituitary carcinoma. Henry Ford Hosp Med J 32:61–66PubMedGoogle Scholar
  16. 16.
    Zahedi A, Booth GL, Smyth HS et al (2001) Distinct clonal composition of primary and metastatic adrencorticotrophic hormoneproducing pituitary carcinoma. Clin Endocrinol (Oxf) 55:549–556. doi: 10.1046/j.1365-2265.2001.01322.x CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Eberval Gadelha Figueiredo
    • 1
  • Wellingson Silva Paiva
    • 1
  • Manoel Jacobsen Teixeira
    • 1
  1. 1.Division of Neurological SurgeryUniversity of São Paulo, School of MedicineSão PauloBrazil

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