Giant pituitary macroadenoma of stem cell origin: illustrative case.
ACA = anterior cerebral artery
CTA = computed tomography angiography
DWI = diffusion weighted imaging
ICA = internal carotid artery
MCA = middle cerebral artery
MRI = magnetic resonance imaging
OCT = optical coherence tomography
giant macroadenoma
pituitary adenoma
stem cells
transsphenoidal resection
visual dysfunction
Journal
Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676
Informations de publication
Date de publication:
08 Mar 2021
08 Mar 2021
Historique:
received:
10
01
2021
accepted:
13
01
2021
entrez:
20
7
2022
pubmed:
8
3
2021
medline:
8
3
2021
Statut:
epublish
Résumé
Giant pituitary macroadenomas with a diameter >4 cm are rare tumors, accounting for only about 5% of pituitary adenomas. They are more difficult to maximally resect safely owing to limited access as well as encasement of adjacent structures. Acidophil stem cell adenomas are rare immature neoplasms proposed to derive from common progenitor cells of somatotroph and lactotroph cells. These adenomas comprise about 4.3% of surgically removed pituitary adenomas. No previous reports have described acidophil stem cell adenomas that grow to the size of giant macroadenomas. This rare entity poses special challenges given the need for maximal safe resection in an immature neoplasm. The authors report a 21-year-old female who presented with 3 years of progressive visual decline and a giant macroadenoma. She underwent endoscopic transsphenoidal surgery for decompression. Given the tumor size and involvement of adjacent critical structures, gross-total resection was not achieved. The authors review the literature on giant pituitary adenomas and provide a discussion on clinical management for this rare entity. The authors present a very rare case of a giant pituitary adenoma of acidophil stem cell origin and discuss the technical and management challenges in this rare entity.
Sections du résumé
BACKGROUND
BACKGROUND
Giant pituitary macroadenomas with a diameter >4 cm are rare tumors, accounting for only about 5% of pituitary adenomas. They are more difficult to maximally resect safely owing to limited access as well as encasement of adjacent structures. Acidophil stem cell adenomas are rare immature neoplasms proposed to derive from common progenitor cells of somatotroph and lactotroph cells. These adenomas comprise about 4.3% of surgically removed pituitary adenomas. No previous reports have described acidophil stem cell adenomas that grow to the size of giant macroadenomas. This rare entity poses special challenges given the need for maximal safe resection in an immature neoplasm.
OBSERVATIONS
METHODS
The authors report a 21-year-old female who presented with 3 years of progressive visual decline and a giant macroadenoma. She underwent endoscopic transsphenoidal surgery for decompression. Given the tumor size and involvement of adjacent critical structures, gross-total resection was not achieved. The authors review the literature on giant pituitary adenomas and provide a discussion on clinical management for this rare entity.
LESSONS
CONCLUSIONS
The authors present a very rare case of a giant pituitary adenoma of acidophil stem cell origin and discuss the technical and management challenges in this rare entity.
Identifiants
pubmed: 35855437
doi: 10.3171/CASE2122
pii: CASE2122
pmc: PMC9241200
doi:
Types de publication
Case Reports
Langues
eng
Pagination
CASE2122Informations de copyright
© 2021 The authors.
Déclaration de conflit d'intérêts
Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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