Composite pituitary adenoma and craniopharyngioma?: An unusual sellar neoplasm with divergent differentiation Journal Article
| Authors: | Yoshida, A.; Sen, C.; Asa, S. L.; Rosenblum, M. K. |
| Article Title: | Composite pituitary adenoma and craniopharyngioma?: An unusual sellar neoplasm with divergent differentiation |
| Abstract: | We report a young man who presented with atrial fibrillation and was subsequently found to have a markedly elevated serum thyroid stimulating hormone level and a solid, noncalcified intrasellar mass on imaging. The patient was treated with thyroid radioablation and hormone replacement and followed for 7 years, during which time the tumor grew to 4.6cm. He had no visual disturbances or other hormonal symptoms. At transsphenoidal surgery, a tumor consisting of a pituitary adenoma and adamantinomatous craniopharyngiomalike components was resected. Both components were closely intermingled, but there was no evidence of an intermediate morphologic phenotype. Immunohistochemically, the adenoma was not only positive for β-thyroid stimulating hormone, α subunit, and pituitary transcription factor 1, but also stained for β-follicle stimulating hormone, steroidogenic factor-1, adrenocorticotropic hormone, and pituitary-restricted transcription factor (Tpit), exhibiting an unusual plurihormonal profile. The craniopharyngiomalike component showed immunoreactivity for steroidogenic factor-1, one of the pituitary transcription factors. This lesion may represent an unusual composite tumor attributable to divergent differentiation of a common precursor. Alternatively, it may be viewed as a pituitary adenoma showing metaplastic change analogous to the development of squamous cell nests of the pars tuberalis from adenohypophyseal endocrine cells. © 2008 by Lippincott Williams & Wilkins. |
| Keywords: | immunohistochemistry; adult; human tissue; metaplasia; histopathology; anamnesis; case report; nuclear magnetic resonance imaging; neurosurgery; magnetic resonance imaging; phenotype; metabolism; pathology; immunoreactivity; adenoma; laboratory test; craniopharyngioma; protein subunit; hyperthyroidism; heart atrium fibrillation; atrial fibrillation; multiple cancer; neoplasms, multiple primary; secretion; thyrotropin; neurosurgical procedures; synaptophysin; hormone blood level; chromogranin a; hypophysis tumor; sella turcica tumor; composite tumor; pituitary adenoma; transcription factor pit 1; hypophysis adenoma; transsphenoidal surgery; pituitary neoplasms |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 32 |
| Issue: | 11 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-11-01 |
| Start Page: | 1736 |
| End Page: | 1741 |
| Language: | English |
| DOI: | 10.1097/PAS.0b013e3181753abd |
| PUBMED: | 18769335 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 17 November 2011" - "CODEN: AJSPD" - "Source: Scopus" |
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