Endocrine Pathology

, Volume 12, Issue 3, pp 329–341 | Cite as

Corticotroph pituitary carcinoma: Case report and literature review

  • David J. Holthouse
  • Peter D. Robbins
  • Richard Kahler
  • Neville Knuckey
  • Peter Pullan
Case Report

Abstract

Pituitary carcinomas, currently defined as primary adenohypophyseal neoplasms with evidence of either brain invasion or metastatic spread, are exceptionally rare. A case of corticotroph pituitary carcinoma is reported. A 17-yr-old female first presented with an invasive and clinically nonfunctioning pituitary macroadenoma. The primary pituitary lesion lacked atypical histological features and retrospective immunohistochemical studies confirmed its corticotrophic nature. Repeated episodes of local recurrence followed together with the acquisition of severe Cushing’s disease. Local disease control was not obtained despite repeated surgical decompression and courses of radiation therapy. Systemic dissemination with multiple bone metastases became manifest eleven years after the first presentation. Atypical histological features and Crooke’s hyaline change were evident in both the recurrent and metastatic disease. She remains alive at last follow-up with severe complications relating to persisting sellar and metastatic disease and ongoing endocrine dysfunction. A further 32 cases of pituitary corticotroph carcinoma reported in English are reviewed to highlight the clinicopathological features of this rare form of pituitary neoplasm. Difficulties associated with the diagnosis and management of pituitary carcinoma are also discussed.

Key Words

Pituitary carcinoma corticotroph metastases Cushing’s disease Crooke’s hyaline change 

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Copyright information

© Humana Press Inc 2001

Authors and Affiliations

  • David J. Holthouse
    • 3
  • Peter D. Robbins
    • 2
  • Richard Kahler
    • 3
  • Neville Knuckey
    • 3
  • Peter Pullan
    • 1
  1. 1.Department of EndocrinologySir Charles Gairdner HospitalPerth
  2. 2.Division of Tissue PathologyThe Western Australian Centre for Pathology and Medical ResearchPerth
  3. 3.Department of NeurosurgerySir Charles Gairdner HospitalNedlands

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