Saeger W, Bosse U, Pfingst E, Schierke G, Kulinna H, Atkins D, Gullotta F
Abteilung für Pathologie, Marienkrankenhauses, Hamburg.
Pathologe. 1995 Sep;16(5):354-8. doi: 10.1007/s002920050114.
A 59-year-old male patient was transnasally operated on because of a pituitary adenoma with hypopituitarism. A second operation and X-ray therapy followed a half year later due to recurrent tumor. Both neoplasmas were classified as sparsely granulated prolactin cell adenomas. Immunohistochemical studies revealed strong immunoreactivity for prolactin and FSH in the tumor cells of both the pituitary adenoma and the recurrent tumor. Two years later the prolactin plasma levels were extremely elevated. A tumor in the liver was identified. Biopsy revealed a solid endocrine tumor containing prolactin by immunohistology. Due to structural and immunohistological similarities this tumor could be identified as a metastasis of the pituitary tumor. After 5 months of therapy the patient died from thrombembolism. Post-mortem studies confirmed the diagnosis of a metastasizing prolactin-secreting pituitary carcinoma. Only six similar cases have been reported in the literature. Our case report confirms the experience with 35 definite pituitary carcinomas reparted in the current literature: malignant pituitary tumors develop after pituitary surgery and can be identified not from the pituitary tumor, but only from its metastases.
一名59岁男性患者因垂体腺瘤伴垂体功能减退接受了经鼻手术。半年后，由于肿瘤复发，进行了二次手术和X线治疗。这两个肿瘤均被分类为稀疏颗粒型催乳素细胞腺瘤。免疫组织化学研究显示，垂体腺瘤和复发性肿瘤的肿瘤细胞中催乳素和促卵泡激素均有强烈免疫反应性。两年后，血浆催乳素水平极度升高。肝脏发现一个肿瘤。活检显示，通过免疫组织学检查，该肿瘤为含有催乳素的实性内分泌肿瘤。由于结构和免疫组织学相似，该肿瘤可被确定为垂体肿瘤的转移灶。经过5个月的治疗，患者死于血栓栓塞。尸检研究证实了转移性分泌催乳素垂体癌的诊断。文献中仅报道了6例类似病例。我们的病例报告证实了当前文献中报道的35例确诊垂体癌的经验：恶性垂体肿瘤在垂体手术后发生，且只能从其转移灶而非垂体肿瘤本身来识别。
