Journal of Neurological Sciences (Turkish) Ahead Of Print
Tumor-to-tumor metastasis: Lung adenocarcinoma into a clinically non-functioning gonadotroph pituitary adenoma: A rare case.
Aydın Sav1, Meriç Adil Altınöz2, Fabio Rotondo3, Matthew Cykowski4, Ali Fahir Özer5, Kalman Kovacs3
1Nişantaşı Pathology Group, Neuropathology, Istanbul,
2Istanbul University, Experimental Medical Research Institute, Istanbul,
3University of Toronto, Pituitary Pathology, Toronto,
4Koç University, Neurosurgery, Istanbul,
5Houston Methodist Hospital, Molecular and Genomic Pathology, Houston,
DOI : 10.24165/jns.9865.16 We report a rare case of a metastatic lung adenocarcinoma to a clinically non-functioning pituitary gonadotroph adenoma in a 66-year-old male experiencing progressive headaches and diminished vision. MR imaging revealed a large tumor containing cystic cavity in the sella turcica and extending into the suprasellar cistern. Immunohistochemistry revealed both pituitary adenoma and metastatic adenocarcinoma containing FSH and LH immunoreactive cells whereas napsin A, TTF-1, cytokeratin7, Pancytokeratin and galectin-3 immunopositivity were evidenced by adenocarcinoma cells within sinusoids and around blood vessels. The transthoracic fine needle biopsy was positive for adenocarcinoma (Napsin-A positive, p63 negative). Primary metastasis to pituitary gland is rare with the most common primary sites include lung, breast, kidney and the gastrointestinal tract. Although rare, any case with progressive local pressure symptoms and endocrinologic stigmata with or without other signs of malignancy requires further examination to rule out pituitary metastasis. Keywords : FSH/LH cell adenoma, gonadotroph cell adenoma, immunohistochemistry, metastatic lung adenocarcinoma, pathology; tumor-to-tumor metastasis;