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Journal of Neurosurgical Sciences 2016 June;60(2):272-80

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Response of silent corticotroph pituitary carcinoma to chemotherapy: case report

Lucy HE 1, Jonathan A. FORBES 1, Kevin CARR 2, Hilary HIGHFIELD NICKOLS 3, Andrea UTZ 4, Paul MOOTS 5, Kyle WEAVER 1

1 Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; 2 Department of Neurological Surgery, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA; 3 Division of Neuropathology, Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA; 4 Division of Endocrinology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; 5 Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA


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Silent pituitary corticotroph carcinomas are rare, with only six previously described cases in the literature. We report a patient with a silent pituitary corticotroph adenoma treated with multiple trans-sphenoidal resections. Twelve years after her initial presentation, she returned with leptomeningeal metastases to the posterior fossa, foramen magnum, and numerous other subarachnoid locations involving the spine. Histopathology obtained from the metastatic foci was identical to previous trans-sphenoidal specimens - consistent with the diagnosis of corticotroph pituitary carcinoma. A carboplatin and etoposide chemotherapy regimen successfully arrested disease progression and produced regression of multiple radiographically documented leptomeningeal deposits. To the authors’ knowledge, this is the first report of a patient with silent pituitary carcinoma treated successfully with chemotherapy.

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