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Multiple intracranial recurrent tumors with hyperprolactinemia combined with a parasellar malignant fibrous histiocytoma long after transfrontal surgery and irradiation to a pituitary adenoma

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Abstract

We herein describe a 40-year-old woman with hyperprolactinemia, an empty sella and two extrasellar intracranial recurrent tumors which were revealed 23 years after the first transfrontal craniotomy and 18 years after the second transfrontal surgery and irradiation to a provable prolactin-producing pituitary macroadenoma. One recurrent tumor was in the right orbital apex causing right oculomotor nerve palsy, and the other tumor was in the right apex partispetrosae and foramen jugulare. Although her serum prolactin level decreased after the administration of bromocriptine mesilate, and the size of the two tumors remained unchanged, a malignant fibrous histiocytoma, which might have been induced by the irradiation 18 years before, grew rapidly in the right suprasellar-prepontine cistern to the right pedunculus cerebralis, leading to a poor prognosis. This case confirmed the importance of the life-lasting follow-up of pituitary adenomas treated with surgery and/or irradiation therapy. Not only ectopic recurrence of the primary tumor but also post-irradiation tumors may become apparent long after the removal of the primary tumor.

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References

  1. Lundberg P.O., Drettner B., Hemmingsson A., Stenkvist B., Wide L. The invasive pituitary adenoma. A prolactin-producing tumor. Arch. Neurol. 1977, 34: 742–749.

    Article  CAS  PubMed  Google Scholar 

  2. Virapongse C., Bhimani S., Saewar M., Greenberg A., Kim J. Prolactin-secreting pituitary adenomas: CT appearance in diffuse invasion. Radiology 1984, 152: 447–451.

    CAS  PubMed  Google Scholar 

  3. Gyori E., Gregg P.A., Breach M. Invasive pituitary adenoma coexisting with infiltrating temporal lobe glioma. South. Med. J. 1992, 85: 1134–1137.

    Article  CAS  PubMed  Google Scholar 

  4. Gasser R.W., Finkenstedt G., Skrabal F., Twerdy K., Grunert V., Mayr U., Frommhold H., Zur Nedden D., Feichtinger J., Hofstaedter F. Multiple intracranial metastases from a prolactin secreting pituitary tumor. Clin. Endocrinol. 1985, 22: 17–27.

    Article  CAS  Google Scholar 

  5. Scheithauer B.W., Randall R.V., Laws E.R. Jr., Kovacs K.T., Horvath E., Whitaker M.D. Prolactin cell carcinoma of the pituitary. Clinicopathologic, immunohistochemical, and ultrastructural study of a case with cranial and extracranial metastases. Cancer 1985, 55: 598–604.

    Article  CAS  PubMed  Google Scholar 

  6. Popovic E.A., Vattuone J.R., Siu K.H., Busmanis I., Pullar M.J., Dowling J. Malignant prolactinomas. Neurosurgery 1991, 29: 127–130.

    Article  CAS  PubMed  Google Scholar 

  7. Atienza D.M., Vigersky R.J., Lack E.E., Carriaga M., Rusnock E.J., Tsou E., Cerrone F., Kattah J.G., Sausville E. Prolactin-producing pituitary carcinoma with pulmonary metastases. Cancer 1991, 68: 1605–1610.

    Article  CAS  PubMed  Google Scholar 

  8. Walker J.D., Grossman A., Anderson J.V., Ur E., Trainer P.J., Benn J., Lowy C., Sönksen P.H., Plowman P.N., Lowe D.G., Doniach I., Wass L.A.H., Besser G.M. Malignant prolactinoma with extracranial metastases: a report of three cases. Clin. Endocrinol. 1993, 38: 411–419.

    Article  CAS  Google Scholar 

  9. Assies J., Verhoeff N.P.L.G., Bosch D.A., Hofland L.J. Intracranial dissemination of a macroprolactinoma. Clin. Endocrinol. 1993, 38: 539–546.

    Article  CAS  Google Scholar 

  10. Jones A. Radiation oncogenesis in relation to the treatment of pituitary tumors. Clin. Endocrinol. 1991, 35: 379–397.

    Article  CAS  Google Scholar 

  11. Gonzalez-Vitale J.C., Slavin R.E., McQueen J.D. Radiation-induced intracranial malignant fibrous histiocytoma. Cancer 1976, 37: 2960–2963.

    Article  CAS  PubMed  Google Scholar 

  12. Jefferson G. The invasive adenomas of the anterior pituitary. In: The Sherrington Lectures; vol 3. University of Liverpool Press, Liverpool, 1954, pp. 1–63.

    Google Scholar 

  13. Karga H.J., Alexander J.M., Hedley-Whyte E.T., Klibanski A., Jameson L.J. Ras mutations in human pituitary tumors. J. Clin. Endocrinol. Metab. 1992, 74: 914–919.

    Article  CAS  PubMed  Google Scholar 

  14. Pei L., Melmed S., Scheithauer B., Kovacs K., Prager D. H-ras mutations in human pituitary carcinoma metastases. J. Clin. Endocrinol. Metab. 1994, 78: 842–846.

    CAS  PubMed  Google Scholar 

  15. Gonsky R., Herman V., Melmed S., Fagin J. Transforming DNA sequences present in human prolactin-secreting pituitary tumors. Mol. Endocrinol. 1991, 5: 1687–1695.

    Article  CAS  PubMed  Google Scholar 

  16. Shimon I., Hinton D.R., Weiss M.H., Meled S. Prolactinomas express human heparin-binding secretory transforming gene (hst) protein product: marker of tumour invasiveness. Clin. Endocrinol. 1998, 48: 23–29.

    Article  CAS  Google Scholar 

  17. Larsson C., Skogseid B., Oberg K., Nakamura Y., Nordenskjold M. Multiple endocrine neoplasia type 1 gene maps to chromosome 11 and is lost in insulinoma. Nature 1988, 332: 85–87.

    Article  CAS  PubMed  Google Scholar 

  18. Courseaux A., Grosgeorge J., Gaudray P., Pannett A.A., Forbes S.A., Williamson C., Bassett D., Thakker R.V., Teh B.T., Farnebo F., Shepherd J., Skogseid B., Larsson C., Giraud S., Zhang C.X., Salandre J., Calender A. Definition of the minimal MEN1 candidate area based on a 5-Mb integrated map of proximal 11q13. The European Consortium on MEN1. Genomics 1996, 37: 354–365.

    Article  CAS  PubMed  Google Scholar 

  19. Ponder B.A., Smith D. The MEN II syndromes and the role of the ret proto- oncogene. Adv. Cancer Res. 1996, 70: 179–222.

    Article  CAS  PubMed  Google Scholar 

  20. Scheithauer B.W., Laws E.R. Jr., Kovacs K., Horvath E., Randall R.V., Carney J.A. Pituitary adenomas of the multiple endocrine neoplasia type I syndrome. Semin. Diagn. Pathol. 1987, 4: 205–211.

    CAS  PubMed  Google Scholar 

  21. Cahan W.G., Woodward H.Q., Higinbotham N.L., Stewart F.W., Coley L. Sarcoma arising in irradiated bone. Cancer 1948, 28: 1087–1099.

    Google Scholar 

  22. Robinson E., Neugut A.I., Wylie P. Clinical aspects of postirradiation sarcomas. J. Natl. Cancer Inst. 1988, 80: 233–240.

    Article  CAS  PubMed  Google Scholar 

  23. Amendola B.E., Amendola M.A., McClatchey K.D. Radiation-induced malignant fibrous histiocytoma: a report of five cases including two occurring post whole brain irradiation. Cancer Invest. 1985, 3: 507–513.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Megumi Fujikawa.

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Fujikawa, M., Okamura, K., Sato, K. et al. Multiple intracranial recurrent tumors with hyperprolactinemia combined with a parasellar malignant fibrous histiocytoma long after transfrontal surgery and irradiation to a pituitary adenoma. J Endocrinol Invest 24, 448–453 (2001). https://doi.org/10.1007/BF03351046

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