Shuman William, Loewenstern Joshua, Pai Akila, Bederson Joshua, Shrivastava Raj
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
World Neurosurg. 2019 Feb;122:397-403. doi: 10.1016/j.wneu.2018.10.200. Epub 2018 Nov 4.
Pituitary tumors are common, well-described skull base tumors of sellar origin. However, there are reports of rare ectopic pituitary tumors that are found exclusively outside of the sella turcica. Ectopic pituitary tumors have not been holistically analyzed. This study describes presentation and clinical patterns found among patients with ectopic pituitary tumors.
A comprehensive review of the literature was performed for clinical descriptions of ectopic pituitary tumors. Reports of 85 applicable cases were evaluated.
The most common locations of ectopic pituitary tumors were the sphenoid sinus, clivus, suprasellar space, nasopharynx, and cavernous sinus. The majority of ectopic pituitary tumors were reported as being functional secretory tumors; they were statistically significantly more likely to be functional tumors than sellar pituitary tumors. Adrenocorticotrophic hormone, prolactin, growth hormone, and thyroid-stimulating hormone-secreting tumors were most commonly found. Bone invasion was reported in more than one third of the cases, and malignant transformations were reported in 6 cases. A large majority of patients presented with hormonal, neurologic, or physiologic symptoms.
Ectopic pituitary tumors are a rare entity of pituitary tumors with a presentation that can mimic those of other skull base tumors. Clinical presentation often correlates to location of the tumor. Ectopic pituitary tumors were significantly more likely to be functional secretory tumors. They may also exhibit more aggressive behavior than sellar-located tumors. Ectopic pituitary tumors may be part of a spectrum of presenting pathologies. Further genetic or genomic analysis is necessary to better understand their pathogenesis and clinical presentations.
垂体瘤是常见的、有详尽描述的起源于蝶鞍的颅底肿瘤。然而，有报道称存在罕见的异位垂体瘤，仅在蝶鞍外发现。异位垂体瘤尚未得到全面分析。本研究描述了异位垂体瘤患者的临床表现和临床模式。
对异位垂体瘤的临床描述进行了全面的文献综述。评估了85例适用病例的报告。
异位垂体瘤最常见的部位是蝶窦、斜坡、鞍上间隙、鼻咽和海绵窦。大多数异位垂体瘤被报告为功能性分泌肿瘤；与蝶鞍垂体瘤相比，它们在统计学上更有可能是功能性肿瘤。最常见的是分泌促肾上腺皮质激素、催乳素、生长激素和促甲状腺激素的肿瘤。超过三分之一的病例报告有骨质侵犯，6例报告有恶性转化。绝大多数患者表现出激素、神经或生理症状。
异位垂体瘤是垂体瘤中的一种罕见类型，其表现可与其他颅底肿瘤相似。临床表现通常与肿瘤位置相关。异位垂体瘤更有可能是功能性分泌肿瘤。它们也可能比蝶鞍区肿瘤表现出更具侵袭性的行为。异位垂体瘤可能是一系列呈现病理的一部分。需要进一步的基因或基因组分析来更好地了解其发病机制和临床表现。
