Gamboa NT, Wilkerson C, Kundu B, Sherrod BA, Dailey AT, Couldwell WT. Natural history of pituitary carcinoma with metastasis to the cervical spine: illustrative case.
JOURNAL OF NEUROSURGERY. CASE LESSONS 2023;
5:CASE22363. [PMID:
36647250 PMCID:
PMC9844525 DOI:
10.3171/case22363]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/19/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND
Pituitary carcinoma is a rare tumor of the adenohypophysis with noncontiguous craniospinal dissemination and/or systemic metastases. Given the rarity of this malignancy, there is limited knowledge and consensus regarding its natural history, prognosis, and optimal treatment.
OBSERVATIONS
The authors present the case of a 46-year-old woman initially treated with invasive prolactin-secreting pituitary macroadenoma who developed metastatic disease of the cervical spine 6 years later. The patient presented with acutely worsening compressive cervical myelopathy and required posterior cervical decompression, tumor resection, and instrumented arthrodesis for posterolateral fusion.
LESSONS
This case underscores the importance of long-term monitoring of hormone levels and having a high clinical suspicion for metastatic disease to the spine in patients presenting with acute myelopathy or radiculopathy in the setting of previously treated invasive secreting pituitary adenoma.
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