Gariépy Charles, Champagne Pierre-Olivier
Medicine, Laval University, Quebec City, CAN.
Neurosurgery, Enfant-Jesus Hospital, Laval University, Quebec City, CAN.
Cureus. 2023 Feb 6;15(2):e34676. doi: 10.7759/cureus.34676. eCollection 2023 Feb.
Pituitary composite tumors consisting of metastasis within an adenoma are rare and aggressive entities. We present a case of esophageal adenocarcinoma metastasis at a prolactinoma presenting in a unique fashion and highlight how this case could contribute to a better understanding and early recognition of this condition. The patient was a 65-year-old male who presented with partial palsy of the third and sixth cranial nerves. He had a history of treated esophageal adenocarcinoma. He also had a known small parasellar lesion, with an elevated prolactin. Investigations showed a rapid progression of the parasellar lesion and normalization of prolactin. Partial surgical resection was performed, and pathology confirmed metastasis of the known digestive tract neoplasia. Although extremely rare, dual pathology of pituitary metastasis within adenomas should be considered in the differential diagnosis of sellar masses. Atypical behavior of benign adenomas, including rapid growth, spontaneous normalization of prolactin, or progression despite medical treatment should prompt medical teams to reconsider their diagnosis.
由腺瘤内转移构成的垂体复合瘤是罕见且侵袭性的实体。我们报告一例食管腺癌转移至催乳素瘤的病例，该病例呈现出独特的表现方式，并强调此病例如何有助于更好地理解和早期识别这种情况。患者为一名65岁男性，表现为第三和第六颅神经部分麻痹。他有食管腺癌治疗史。他还已知有一个鞍旁小病变，催乳素升高。检查显示鞍旁病变迅速进展，催乳素恢复正常。进行了部分手术切除，病理证实为已知消化道肿瘤的转移。尽管极为罕见，但在鞍区肿块的鉴别诊断中应考虑腺瘤内垂体转移的双重病理情况。良性腺瘤的非典型表现，包括快速生长、催乳素自发恢复正常或尽管接受治疗仍进展，应促使医疗团队重新考虑其诊断。
