Campbell D, Amponsah Nk, Mott R, Ellis T
Wake Forest Baptist Health, North Carolina, USA.
J Surg Case Rep. 2012 Oct 1;2012(10):12. doi: 10.1093/jscr/2012.10.12.
The authors present the case of a 58-year-old gentleman presenting with atypical carcinoid tumor of primary lung origin metastasizing to a previously identified pituitary macroadenoma. The patient presented with symptoms of headache and visual disturbance. Imaging revealed enlargement of a known sellar mass as well as three separate enhancing lesions in the brain parenchyma. Resection was accomplished via a transnasal transshpenoidal approach without complication. Immunoreactivity was demonstrated to synaptophysin, chromogranin, CD56, epithelial membrane antigen, and thyroid transcription factor-1. The specimen was also marked by negative staining for pituitary hormones. This case demonstrates a rare occurrence of metastastic spread of tumor to a previously identified pituitary macroadenoma.
作者报告了一例58岁男性病例,该患者原发性肺源性非典型类癌转移至先前发现的垂体大腺瘤。患者表现出头痛和视觉障碍症状。影像学检查显示已知的蝶鞍区肿块增大,以及脑实质内三个独立的强化病灶。通过经鼻蝶窦入路完成了切除术,无并发症。免疫反应显示突触素、嗜铬粒蛋白、CD56、上皮膜抗原和甲状腺转录因子-1呈阳性。标本对垂体激素染色也呈阴性。该病例显示肿瘤转移至先前发现的垂体大腺瘤的情况罕见。