Natural history of pituitary carcinoma with metastasis to the cervical spine: illustrative case

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. The authors present the...

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Published inJournal of neurosurgery. Case lessons Vol. 5; no. 3
Main Authors Gamboa, Nicholas T, Wilkerson, Christopher, Kundu, Bornali, Sherrod, Brandon A, Dailey, Andrew T, Couldwell, William T
Format Journal Article
LanguageEnglish
Published United States American Association of Neurological Surgeons 16.01.2023
Subjects
Case Lesson
spine tumor
pituitary carcinoma
spinal metastases
intradural extramedullary mass
prolactinoma
cervical myelopathy
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Summary: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. 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. 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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Disclosures Dr. Sherrod reported grants from AO Spine Foundation outside the submitted work. Dr. Dailey reported personal fees from Zimmer Biomet and personal fees from AO North America outside the submitted work. No other disclosures were reported.
INCLUDE WHEN CITING Published January 16, 2023; DOI: 10.3171/CASE22363.
ISSN:2694-1902
2694-1902
DOI:10.3171/CASE22363