TY - JOUR
T1 - Distant Pituitary Adenoma Spread
T2 - A Systematic Review and Report of 2 Cases
AU - Azizkhanian, Ida
AU - El Ahmadieh, Tarek Y.
AU - Palmisciano, Paolo
AU - Abou-Mrad, Zaki
AU - Daoud, Elena V.
AU - Essibayi, Muhammed Amir
AU - Connors, Scott
AU - Aoun, Salah G.
AU - Kim, Jun
AU - Hatanpaa, Kimmo J.
AU - Garzon-Muvdi, Tomas
AU - Barnett, Samuel L.
AU - Patel, Toral
AU - Raisanen, Jack M.
AU - Mickey, Bruce E.
N1 - Publisher Copyright:
Copyright © Congress of Neurological Surgeons 2022. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - BACKGROUND: Distant spread of pituitary adenoma outside the sellar/suprasellar region is classified as pituitary carcinoma. Cerebrospinal fluid (CSF)-born spread of pituitary adenoma can occur after tumor cell spillage into the CSF space after surgery, irradiation, or apoplexy and is not necessarily related to intrinsic tumor biology. OBJECTIVE: To systematically review the literature and describe the clinical characteristics and treatment strategies of patients with pituitary carcinomas. We further present 2 cases from our institution. METHODS: A single-center retrospective review of patients with pituitary adenoma spread to distant intracranial locations between 2000 and 2020 was performed. Electronic databases were searched from their inception to May 25, 2021, and studies describing patients with pituitary spread to distant locations were included. RESULTS: Of 1210 pituitary adenoma cases reviewed, 2 (0.16%) showed tumor spread to distant locations. We found 134 additional cases (from 108 published articles) resulting in a total of 136 cases (61.9% were male). The time to tumor spread ranged between 0 and 516 months (median: 96 months). The follow-up duration ranged between 0 and 240 months (median: 11.5 months). All but 2 patients (98.5%) underwent surgical resection before adenoma spread. The 2 exceptions included a patient with evidence of an apoplectic event on autopsy and another patient with leptomeningeal pituitary spread but an unclear history of apoplexy. Elevated tumor markers were not linked to poor outcomes. CONCLUSION: Distant spread of pituitary adenoma may occur after surgery, irradiation, or apoplexy. It is not necessarily associated with a malignant clinical course.
AB - BACKGROUND: Distant spread of pituitary adenoma outside the sellar/suprasellar region is classified as pituitary carcinoma. Cerebrospinal fluid (CSF)-born spread of pituitary adenoma can occur after tumor cell spillage into the CSF space after surgery, irradiation, or apoplexy and is not necessarily related to intrinsic tumor biology. OBJECTIVE: To systematically review the literature and describe the clinical characteristics and treatment strategies of patients with pituitary carcinomas. We further present 2 cases from our institution. METHODS: A single-center retrospective review of patients with pituitary adenoma spread to distant intracranial locations between 2000 and 2020 was performed. Electronic databases were searched from their inception to May 25, 2021, and studies describing patients with pituitary spread to distant locations were included. RESULTS: Of 1210 pituitary adenoma cases reviewed, 2 (0.16%) showed tumor spread to distant locations. We found 134 additional cases (from 108 published articles) resulting in a total of 136 cases (61.9% were male). The time to tumor spread ranged between 0 and 516 months (median: 96 months). The follow-up duration ranged between 0 and 240 months (median: 11.5 months). All but 2 patients (98.5%) underwent surgical resection before adenoma spread. The 2 exceptions included a patient with evidence of an apoplectic event on autopsy and another patient with leptomeningeal pituitary spread but an unclear history of apoplexy. Elevated tumor markers were not linked to poor outcomes. CONCLUSION: Distant spread of pituitary adenoma may occur after surgery, irradiation, or apoplexy. It is not necessarily associated with a malignant clinical course.
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U2 - 10.1227/ONS.0000000000000089
DO - 10.1227/ONS.0000000000000089
M3 - Article
C2 - 35030115
AN - SCOPUS:85124636662
VL - 22
SP - 131
EP - 143
JO - Operative Neurosurgery
JF - Operative Neurosurgery
SN - 2332-4252
IS - 3
ER -