Pituitary atypical adenoma or malignant corticotrophinoma?.
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544 |
Resumo: | Pituitary tumors are classified into typical adenomas, atypical adenomas or carcinomas. Carcinoma represents 0.2% of pituitary tumors and is defined by the presence of metastases. It often presents as invasive and secreting macroadenoma, showing features of malignancy ab initio or over time. The high proliferative index (Ki-67) and immunostaining for p53 protein are common indicators of aggressiveness. We report a 58 years old male with invasive sellar incidentaloma. The hormonal study showed gonadal, thyroid, and somatotrophic failure, with increase of corticotropin (ACTH) and cortisol. Transsphenoidal surgery was performed and histology revealed a typical corticotrophinoma. The successive recurrences over 10 years led to five surgical reoperation and radiotherapy. After the third surgery, cellular atypia, Ki-67 of 27% and immunostaining for p53 were revealed. Subsequently, there were lesions suspicious of metastases (lung and lymph nodes), but the biopsy of the lymph nodes was inconclusive. The patient died before chemotherapy. In this case, the progressive loss of differentiation points to the need for early diagnosis, timely and aggressive treatment. |
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Pituitary atypical adenoma or malignant corticotrophinoma?.Adenoma atípico da hipófise ou corticotrofinoma maligno?Pituitary tumors are classified into typical adenomas, atypical adenomas or carcinomas. Carcinoma represents 0.2% of pituitary tumors and is defined by the presence of metastases. It often presents as invasive and secreting macroadenoma, showing features of malignancy ab initio or over time. The high proliferative index (Ki-67) and immunostaining for p53 protein are common indicators of aggressiveness. We report a 58 years old male with invasive sellar incidentaloma. The hormonal study showed gonadal, thyroid, and somatotrophic failure, with increase of corticotropin (ACTH) and cortisol. Transsphenoidal surgery was performed and histology revealed a typical corticotrophinoma. The successive recurrences over 10 years led to five surgical reoperation and radiotherapy. After the third surgery, cellular atypia, Ki-67 of 27% and immunostaining for p53 were revealed. Subsequently, there were lesions suspicious of metastases (lung and lymph nodes), but the biopsy of the lymph nodes was inconclusive. The patient died before chemotherapy. In this case, the progressive loss of differentiation points to the need for early diagnosis, timely and aggressive treatment.Pituitary tumors are classified into typical adenomas, atypical adenomas or carcinomas. Carcinoma represents 0.2% of pituitary tumors and is defined by the presence of metastases. It often presents as invasive and secreting macroadenoma, showing features of malignancy ab initio or over time. The high proliferative index (Ki-67) and immunostaining for p53 protein are common indicators of aggressiveness. We report a 58 years old male with invasive sellar incidentaloma. The hormonal study showed gonadal, thyroid, and somatotrophic failure, with increase of corticotropin (ACTH) and cortisol. Transsphenoidal surgery was performed and histology revealed a typical corticotrophinoma. The successive recurrences over 10 years led to five surgical reoperation and radiotherapy. After the third surgery, cellular atypia, Ki-67 of 27% and immunostaining for p53 were revealed. Subsequently, there were lesions suspicious of metastases (lung and lymph nodes), but the biopsy of the lymph nodes was inconclusive. The patient died before chemotherapy. In this case, the progressive loss of differentiation points to the need for early diagnosis, timely and aggressive treatment.Ordem dos Médicos2011-12-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544oai:ojs.www.actamedicaportuguesa.com:article/1544Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 3; 661-6Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 3; 661-61646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544/1129Alves, MárciaPaiva, IsabelBelo, FranciscoRebelo, OlindaBastos, MargaridaCarvalheiro, Manuelainfo:eu-repo/semantics/openAccess2022-12-20T10:58:05ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Pituitary atypical adenoma or malignant corticotrophinoma?. Adenoma atípico da hipófise ou corticotrofinoma maligno? |
title |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
spellingShingle |
Pituitary atypical adenoma or malignant corticotrophinoma?. Alves, Márcia |
title_short |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
title_full |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
title_fullStr |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
title_full_unstemmed |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
title_sort |
Pituitary atypical adenoma or malignant corticotrophinoma?. |
author |
Alves, Márcia |
author_facet |
Alves, Márcia Paiva, Isabel Belo, Francisco Rebelo, Olinda Bastos, Margarida Carvalheiro, Manuela |
author_role |
author |
author2 |
Paiva, Isabel Belo, Francisco Rebelo, Olinda Bastos, Margarida Carvalheiro, Manuela |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Alves, Márcia Paiva, Isabel Belo, Francisco Rebelo, Olinda Bastos, Margarida Carvalheiro, Manuela |
description |
Pituitary tumors are classified into typical adenomas, atypical adenomas or carcinomas. Carcinoma represents 0.2% of pituitary tumors and is defined by the presence of metastases. It often presents as invasive and secreting macroadenoma, showing features of malignancy ab initio or over time. The high proliferative index (Ki-67) and immunostaining for p53 protein are common indicators of aggressiveness. We report a 58 years old male with invasive sellar incidentaloma. The hormonal study showed gonadal, thyroid, and somatotrophic failure, with increase of corticotropin (ACTH) and cortisol. Transsphenoidal surgery was performed and histology revealed a typical corticotrophinoma. The successive recurrences over 10 years led to five surgical reoperation and radiotherapy. After the third surgery, cellular atypia, Ki-67 of 27% and immunostaining for p53 were revealed. Subsequently, there were lesions suspicious of metastases (lung and lymph nodes), but the biopsy of the lymph nodes was inconclusive. The patient died before chemotherapy. In this case, the progressive loss of differentiation points to the need for early diagnosis, timely and aggressive treatment. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-12-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544 oai:ojs.www.actamedicaportuguesa.com:article/1544 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/1544 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1544/1129 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 3; 661-6 Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 3; 661-6 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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1777301632036372480 |