Crusius Paulo S, Forcelini Cassiano M, Mallmann Adroaldo B, Silveira Daniela A, Lersch Elder, Seibert Cláudio A, Crusius Marcelo U, Carazzo Charles A, Crusius Cassiano U, Goellner Eduardo
Institute of Neurology and Neurosurgery, Passo Fundo, RS, Brazil.
Arq Neuropsiquiatr. 2005 Sep;63(3B):864-9. doi: 10.1590/s0004-282x2005000500029. Epub 2005 Oct 18.
Pituitary carcinomas are rare neoplasms characterized by craniospinal and/or systemic metastases originated from the pituitary. Their histopathology is frequently indistinguishable from that of benign adenomas. The development of markers that better reflect their behavior is desirable. We present the case of a 47 year-old man with a prolactin-secreting macroadenoma who was submitted to surgeries, cranial radiation therapy, and bromocriptine treatment, but evolved to a fatal outcome after the disclosure of intracranial metastases. Tumor samples underwent p53 and Ki-67 immunohistochemical assessment. p53 was absent in all samples, a rare finding among pituitary carcinomas. Ki-67 proliferative index was 2.80% in the original tumor, 4.40% in the relapse, and 4.45% in the metastasis. The figure in the relapse is higher than the expected for a noninvasive adenoma. In conclusion, p53 staining is not positive in all pituitary carcinomas. A high Ki-67 proliferative index in a pituitary adenoma might indicate a more aggressive behavior.
垂体癌是一种罕见的肿瘤，其特征是起源于垂体的颅脊髓和/或全身转移。它们的组织病理学通常与良性腺瘤难以区分。开发能更好反映其行为的标志物很有必要。我们报告一例47岁分泌催乳素的大腺瘤男性患者，该患者接受了手术、颅部放射治疗和溴隐亭治疗，但在颅内转移出现后最终死亡。对肿瘤样本进行了p53和Ki-67免疫组化评估。所有样本中均未检测到p53，这在垂体癌中是罕见的发现。原肿瘤的Ki-67增殖指数为2.80%，复发时为4.40%，转移时为4.45%。复发时的数值高于非侵袭性腺瘤的预期值。总之，并非所有垂体癌的p53染色均呈阳性。垂体腺瘤中高Ki-67增殖指数可能表明其行为更具侵袭性。
