Document Detail


Pituitary carcinoma recurrent to the lumbar intradural extramedullary space: case report.
MedLine Citation:
PMID:  22333938     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Pituitary tumors are rare, and pituitary carcinomas are rarer still. Prognosis is poor, with less than 50% of patients surviving past 1 year after diagnosis. In this case of spinal metastasis from an adrenocorticotropic hormone-secreting pituitary carcinoma, the intradural extramedullary metastases recurred in the same lumbar area 6 years apart.
FINDINGS: Fourteen years prior to presentation in our clinic, a 48-year-old woman was diagnosed with pituitary adenoma which was treated with resection followed by radiation. Eight years later, an intradural extramedullary spinal drop metastasis at L2-L3 was again treated with resection and radiation. Three years later, magnetic resonance imaging (MRI) revealed a mass encasing the right carotid artery, which was treated for 1 year with chemotherapy using temozolomide (Temodar). Three years later, MRI showed intradural extramedullary metastases at the L3-L4 intervertebral disc space and behind the L3 vertebral body; treatment was again resection followed by radiation. Back pain and weakness resolved after surgery and her neurological examination returned to baseline. There was no evidence of recurrence 1 year after surgery.
CONCLUSION/CLINICAL RELEVANCE: In this unusual case, this pituitary carcinoma metastasized twice in 6 years to virtually the same intradural extramedullary lumbar region. Surgical resection of these masses aided in relieving neurological symptoms and prolonging life.
Authors:
Paul M Arnold; Denesh Ratnasingam; Maura F O'Neil; Philip L Johnson
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-02-08
Journal Detail:
Title:  The journal of spinal cord medicine     Volume:  35     ISSN:  1079-0268     ISO Abbreviation:  J Spinal Cord Med     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-06-21     Revised Date:  2013-04-15    
Medline Journal Info:
Nlm Unique ID:  9504452     Medline TA:  J Spinal Cord Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  118-21     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS 66160, USA. parnold@kumc.edu
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MeSH Terms
Descriptor/Qualifier:
Carcinoma / pathology*
Female
Humans
Lumbosacral Region
Magnetic Resonance Imaging
Middle Aged
Pituitary Neoplasms / pathology*
Spinal Cord Neoplasms / secondary*
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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