Unusual Case of Metastatic Neuroendocrine Tumor |
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Institution: | 1. Departments of Surgery and Johns Hopkins Medical Institutions, Baltimore, Maryland.;2. Endocrinology, Johns Hopkins Medical Institutions, Baltimore, Maryland.;1. Department of Endocrinology, Diabetes & Metabolism, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;2. Department of Pathology, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;3. Department of Radiology, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;4. Department of Neurosurgery, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;5. Department of Otolaryngology- Head and Neck Surgery, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;6. Department of Ophthalmology, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA;7. Department of Neurology, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, USA |
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Abstract: | ObjectiveTo report a rare case of metastatic growth hormone (GH)-secreting pituitary carcinoma causing acromegaly.MethodsWe present a case report and review the available literature on this topic.ResultsA 68-year-old woman presented with persistent acromegaly after treatment for a GH-secreting pituitary adenoma. Evaluation of long-standing cervical adenopathy revealed findings consistent with a metastatic neuroendocrine tumor. Further work-up revealed additional thyroid, parathyroid, and cervical masses. After operative treatment including total thyroidectomy, subtotal parathyroidectomy, partial thymectomy, and right modified radical neck dissection, the patient’s symptoms diminished, and her GH levels approached the normal range. Surgical pathology findings were consistent with a GH-secreting pituitary carcinoma metastatic to the cervical lymph nodes, multinodular thyroid hyperplasia with a focus of papillary microcarcinoma, and parathyroid hyperplasia.ConclusionOverall, pituitary carcinomas are extremely rare. To date, about 100 cases have been reported in the world’s literature, and of these, only 19 cases originated from GH-secreting cells. Our examination of the symptoms, signs, diagnosis, and treatment of our patient, in comparison with the previously reported cases, should enhance awareness of this unusual disease process. (Endocr Pract. 2007;13:72-76) |
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