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Acromegaly due to an ectopic pituitary adenoma in the clivus: case report and review of literature

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Abstract

Pituitary adenomas rarely originate outside the sella turcica. Ectopic locations include the suprasellar region, sphenoid sinus, cavernous sinus and clivus. We describe a 50-year-old female who presented with clinical signs and biochemical evidence of acromegaly. Pituitary MRI demonstrated a 2 mm hypointense lesion on the right side of the pituitary gland. However upon drilling of the upper clival bone to expose the sella during endoscopic transsphenoidal surgery, soft tumor-like tissue was encountered within the clivus. Exploration of the sella, including the area of hypointensity noted on preoperative imaging, did not identify any other abnormality. Immunohistochemical examination of the fully resected tumor demonstrated growth hormone immunoreactivity. Failed preoperative diagnosis of this rare ectopic GH-producing tumor was compounded by the presence of a misleading pituitary abnormality consistent with a microadenoma. The epidemiology and pertinent literature of this uncommon condition is discussed.

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Authors and Affiliations

  1. Department of Medicine, David Geffen School of Medicine at UCLA, 9-240 N Factor Building, Los Angeles, CA, 90095, USA

    Julia Goulart Appel & Anthony P. Heaney

  2. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, USA

    Marvin Bergsneider & Anthony P. Heaney

  3. Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, USA

    Harry Vinters

  4. Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, USA

    Noriko Salamon

  5. Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, USA

    Marilene B. Wang

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  1. Julia Goulart Appel
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  2. Marvin Bergsneider
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  3. Harry Vinters
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  4. Noriko Salamon
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  5. Marilene B. Wang
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  6. Anthony P. Heaney
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Corresponding author

Correspondence to Anthony P. Heaney.

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Appel, J.G., Bergsneider, M., Vinters, H. et al. Acromegaly due to an ectopic pituitary adenoma in the clivus: case report and review of literature. Pituitary 15 (Suppl 1), 53–56 (2012). https://doi.org/10.1007/s11102-011-0345-9

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  • DOI: https://doi.org/10.1007/s11102-011-0345-9

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