‘Ectopic’ suprasellar type IIa PRL-secreting pituitary adenoma
- 205 Downloads
Ectopic pituitary adenomas (EPAs) are rare, and the suprasellar cistern seems to be the most common location. At this time, no detailed original classification, diagnosis, or treatment protocols for suprasellar pituitary adenomas (SPAs) have been described.
A 19-year-old man showed visual disturbances and lack of libido for 3 years, he suffered a sharp decline in vision with only light perception in the last week. Magnetic resonance imaging scans revealed a large suprasellar cystic lesion with a normal pituitary in the sella turcica. Endocrinological findings showed an extremely high prolactin level of 1250 ng/mL. Because of the sharp decline in vision, the patient underwent total removal of the suprasellar lesion using a transfrontal interhemispheric approach. The tumor pedicle originated in the lower pituitary stalk without any connection to the anterior pituitary gland in the sella turcica, while the diaphragma sellae was incomplete. Clinical and endocrinological cure criteria were fulfilled and postoperative pathology confirmed a prolactin-secreting pituitary adenoma.
Ectopic suprasellar pituitary adenomas (ESPAs) are extremely rare intracranial extracerebral tumors. SPAs can be classified into three types according to their origin and their relationship with surrounding tissue. Only type III is theoretically a true ectopic, based on previous reports. Thus, ESPAs are uncommon compared to other EPAs. Our case is the first reported case of a type IIa ‘E’SPA and the first description of this subtype classification until now. The pars tuberalis may be different from the pars distalis, and each subtype of adenohypophyseal cells may have different migration characteristics, which leads to different proportions of each hormone-secreting subtype in SPAs and EPAs. Transsphenoidal surgery is minimally invasive, but transcranial surgery may remain a universal option for the treatment of suprasellar lesions.
KeywordsEctopic suprasellar pituitary adenoma Suprasellar Pituitary adenoma Subdiaphragmatic Supradiaphragmatic Diaphragma sellae
This article is supported by a national clinical key specialty construction project in China.
Compliance with ethical standards
Conflict of interest
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
- 2.Erdheim J (1909) Über einen Hypophysentumor von ungewöhnlichem Sitz. Beitr Pathol Anat 46:233–240Google Scholar
- 39.Wang Q, Lu XJ, Sun J, Wang J, Huang CY, Wu ZF (2016) Ectopic suprasellar thyrotropin-secreting pituitary adenoma: case report and literature review. World Neurosurg 617:E13–E18Google Scholar