Skip to main content

Advertisement

SpringerLink
Log in

Sclerosing Epithelioid Fibrosarcoma of the Pituitary

  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

Primary pituitary sarcoma in the absence of previous radiation therapy is very rare, only eight cases having been reported. We present the first reported case of sclerosing epithelioid fibrosarcoma of the pituitary, a 56-year-old woman presenting with diplopia and panhypopituitarism. Magnetic resonance imaging showed a 1.2 × 0.4 × 0.5-cm sellar mass invading the right cavernous sinus. Despite surgery and radiation therapy, our patient developed intracranial metastases and died 2 years after the initial diagnosis. Sclerosing epithelioid fibrosarcoma is an infrequently occurring, distinct variant of soft tissue fibrosarcoma. Its immunophenotype includes vimentin and occasionally CD-34, B cell lymphoma-2, S-100 protein, or keratin expression. Although initially thought to be a low-grade lesion, sclerosing epithelioid fibrosarcomas may also behave in a high-grade manner.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Freda PU, Post KD. Differential diagnosis of sellar masses. Endocrinol Metab Clin North Am 28(1):81–117, 1999.

    Article  PubMed  CAS  Google Scholar 

  2. Gagneja H, Arafah B, Taylor HC. Histologically proven lymphocytic hypophysitis: spontaneous resolution and subsequent pregnancy. Mayo Clin Proc 74(2):150–4, 1999.

    PubMed  CAS  Google Scholar 

  3. Taylor HC, Wilson DJ, Schumacher OP. Pituitary stones and associated hypopituitarism. JAMA 242(8):751–2, 1979.

    Article  PubMed  CAS  Google Scholar 

  4. Wesseling P, Brat DJ, Fuller GN. Pituicytoma. In: Louis DN, Ohgaki H, Wiestler OD, et al, eds. 2007 Word Health Organization classification of tumours of the central nervous system. Geneva, Switzerland: WHO, pp. 243–4, 2007.

    Google Scholar 

  5. Fults D, Kelly DL Jr. A suprasellar atypical teratoma presenting as an intrasellar mass: a case report. Neurosurgery 13(1):40–3, 1983.

    Article  PubMed  CAS  Google Scholar 

  6. Urbanski SJ, Bilbao JM, Horvath E, Kovacs K, So W, Ward JV. Intrasellar solitary plasmacytoma terminating in multiple myeloma: a report of a case including electron microscopical study. Surg Neurol 14(3):233–6, 1980.

    PubMed  CAS  Google Scholar 

  7. Ashkan K, Papadopoulos MC, Casey AT, Thompson DN, Jarvis S, Powell M, Thomas DG. Sellar tuberculoma: report of two cases. Acta Neurochir (Wien) 139(6):523–5, 1997.

    Article  CAS  Google Scholar 

  8. Voulgaris SG, Partheni M, Tzortzidis F. Suprasellar and intrasellar paragangliomas. Clin Neuropathol 25(5):221–6, 2006.

    PubMed  CAS  Google Scholar 

  9. Moreland DB. Intrasellar pituitary schwannoma. J Clin Neurosci 13(7):771–4, 2006.

    Article  PubMed  Google Scholar 

  10. Jones A. Radiation oncogenesis in relation to the treatment of pituitary tumours. Clin Endocrinol (Oxf) 35(5):379–97, 1991.

    CAS  Google Scholar 

  11. Moro M, Giannini C, Scheithauer BW, Lloyd RV, Restall P, Eagleton C, Law AJ, Kovacs K. Combined sellar fibrosarcoma and prolactinoma with neuronal metaplasia: report of a case unassociated with radiotherapy. Endocr Pathol 15(2):149–58, 2004.

    Article  PubMed  Google Scholar 

  12. Meis-Kindblom JM, Kindblom LG, Enzinger FM. Sclerosing epithelioid fibrosarcoma. A variant of fibrosarcoma simulating carcinoma. Am J Surg Pathol 19(9):979–93, 1995.

    PubMed  CAS  Google Scholar 

  13. Gisselsson D, Andreasson P, Meis-Kindblom JM, Kindblom LG, Mertens F, Mandahl N. Amplification of 12q13 and 12q15 sequences in a sclerosing epithelioid fibrosarcoma. Cancer Genet Cytogenet 107(2):102–6, 1998.

    Article  PubMed  CAS  Google Scholar 

  14. Christensen DR, Ramsamooj R, Gilbert TJ. Sclerosing epithelioid fibrosarcoma: short T2 on MR imaging. Skeletal Radiol 26(10):619–21, 1997.

    Article  PubMed  CAS  Google Scholar 

  15. Eyden BP, Manson C, Banerjee SS, Roberts IS, Harris M. Sclerosing epithelioid fibrosarcoma: a study of five cases emphasizing diagnostic criteria. Histopathology 33(4):354–60, 1998.

    Article  PubMed  CAS  Google Scholar 

  16. Antonescu CR, Rosenblum MK, Pereira P, Nascimento AG, Woodruff JM. Sclerosing epithelioid fibrosarcoma: a study of 16 cases and confirmation of a clinicopathologically distinct tumor. Am J Surg Pathol 25(6):699–709, 2001.

    Article  PubMed  CAS  Google Scholar 

  17. Hansen T, Katenkamp K, Brodhun M, Katenkamp D. Low-grade fibrosarcoma report on 39 not otherwise specified cases and comparison with defined low grade fibrosarcoma types. Histopathology 49(2):152–60, 2006.

    Article  PubMed  CAS  Google Scholar 

  18. Reid R, Barrett A, Hamblen DL. Sclerosing epithelioid fibrosarcoma. Histopathology 28(5):451–5, 1996.

    Article  PubMed  CAS  Google Scholar 

  19. Bilsky MH, Schefler AC, Sandberg DI, Dunkel IJ, Rosenblum MK. Sclerosing epithelioid fibrosarcomas involving the neuraxis: report of three cases. Neurosurgery 47(4):956–9, 2000 (discussion 959–960).

    Article  PubMed  CAS  Google Scholar 

  20. Brada M, Ford D, Ashley S, Bliss JM, Crowley S, Mason M, Rajan B, Traish D. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. BMJ 304(6838):1343–6, 1992.

    Article  PubMed  CAS  Google Scholar 

  21. Amendola BE, Amendola MA, McClatchey KD, Miller CH Jr. Radiation associated sarcoma: a review of 23 patients with postradiation sarcoma over a 50-year period. Am J Clin Oncol 12(5):411–5, 1989.

    Article  PubMed  CAS  Google Scholar 

  22. Burger PC, Scheithauer BW. Tumors and tumor-like lesions of mesenchymal tissue (Chapter 10). In: Burger PC, Scheithauer BW, eds. Atlas of tumor pathology-tumors of the central nervous system, fourth series. Fascicle 7. Silver Springs, MD: ARP Press, pp. 373–8, 2007.

    Google Scholar 

  23. Oliveira AM, Scheithauer BW, Salomao DR, Parisi JE, Burger PC, Nascimento AG. Primary sarcomas of the brain and spinal cord: a study of 18 cases. Am J Surg Pathol 26(8):1056–63, 2002.

    Article  PubMed  Google Scholar 

  24. Gaspar LE, Mackenzie IR, Gilbert JJ, Kaufmann JC, Fisher BF, Macdonald DR, Cairncross JG. Primary cerebral fibrosarcomas. Clinicopathologic study and review of the literature. Cancer 72(11):3277–81, 1993.

    Article  PubMed  CAS  Google Scholar 

  25. Chow LT, Lui YH, Kumta SM, Allen PW. Primary sclerosing epithelioid fibrosarcoma of the sacrum: a case report and review of the literature. J Clin Pathol 57(1):90–4, 2004.

    Article  PubMed  CAS  Google Scholar 

  26. Ogose A, Kawashima H, Umezu H, Hotta T, Gu W, Yamagiwa H, Ito T, Tohyama T, Nishijima H, Endo N. Sclerosing epithelioid fibrosarcoma with der(10)t(10;17)(p11;q11). Cancer Genet Cytogenet 152(2):136–40, 2004.

    Article  PubMed  CAS  Google Scholar 

  27. Limon J, Szadowska A, Iliszko M, Babinska M, Mrozek K, Jaskiewicz J, Kopacz A, Roszkiewicz A, Debiec-Rychter M. Recurrent chromosome changes in two adult fibrosarcomas. Genes Chromosomes Cancer 21(2):119–23, 1998.

    Article  PubMed  CAS  Google Scholar 

  28. Donner LR, Clawson K, Dobin SM. Sclerosing epithelioid fibrosarcoma: a cytogenetic, immunohistochemical, and ultrastructural study of an unusual histological variant. Cancer Genet Cytogenet 119(2):127–31, 2000.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors acknowledge the diagnostic assistance of Dr. Antonio G. Nascimento of the Bone and Soft Tissue Working Group, the photographic expertise of Mr. James Hopfenspirger, and the secretarial service of Mrs. Denise Chase, all of Mayo Clinic. Appreciation is likewise extended to Willie Hernandez for manuscript and figure preparation and JoLynne Marsh for secretarial assistance.

Author information

Authors and Affiliations

  1. Fairview Hospital, Cleveland Clinic Health System, 18101 Lorain Avenue, Cleveland, OH, 44111, USA

    Anamaria Massier, Christopher Clark & Luis Llerena

  2. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA

    Bernd W. Scheithauer

  3. Clinical Professor Medicine (Endocrinology), Division of Clinical and Molecular Endocrinology, CWRU School of Medicine, Cleveland, OH, USA

    Harris C. Taylor

Authors
  1. Anamaria Massier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernd W. Scheithauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Harris C. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christopher Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luis Llerena
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luis Llerena.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Massier, A., Scheithauer, B.W., Taylor, H.C. et al. Sclerosing Epithelioid Fibrosarcoma of the Pituitary. Endocr Pathol 18, 233–238 (2007). https://doi.org/10.1007/s12022-007-9010-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12022-007-9010-2

Keywords

Search

Navigation