Mixed pituitary adenoma/craniopharyngioma: clinical, morphological, immunohistochemical and ultrastructural study of a case, review of the literature, and pathogenetic and nosological considerations.

Details

Serval ID
serval:BIB_D41DB765CB5F
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Mixed pituitary adenoma/craniopharyngioma: clinical, morphological, immunohistochemical and ultrastructural study of a case, review of the literature, and pathogenetic and nosological considerations.
Journal
Pituitary
Author(s)
Finzi G., Cerati M., Marando A., Zoia C., Ferreli F., Tomei G., Castelnuovo P., La Rosa S., Capella C.
ISSN
1573-7403 (Electronic)
ISSN-L
1386-341X
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
17
Number
1
Pages
53-59
Language
english
Notes
Publication types: Case Reports ; Journal Article ; ReviewPublication Status: ppublish
Abstract
Mixed pituitary adenoma/craniopharyngiomas are very rare tumors. Their pathogenesis is still unclear and it is not known whether they are collision tumors derived from independent stem cells or whether they originate from a single stem cell undergoing divergent differentiation. The latter hypothesis is supported by the close commixture between the two tumor components with transition areas that has been previously described. However, "hybrid" cells with both pituitary adenoma and craniopharyngioma features have never been described. In this paper we report a case of mixed pituitary adenoma/craniopharyngioma observed in a 75-year-old woman presenting with diplopia and slight increase of serum prolactin, who underwent endoscopic endonasal trans-sphenoidal tumor resection. Histologically, the tumor was composed of a typical pituitary silent subtype 2 ACTH cell adenoma admixed with islands of adamantinomatous craniopharyngioma. Electron microscopy showed that, in addition to distinct silent subtype 2 ACTH and craniopharyngioma cells, there were "hybrid" cells, showing characteristics of both pituitary adenoma and craniopharyngioma, consisting of small dense secretory granules, bundles of cytoplasmic filaments, and desmosomes. This ultrastructural finding was also confirmed by the presence of cells showing nuclear p40 expression and chromogranin A immunoreactivity. The close commixture between the two components and the ultrastructural and immunohistochemical findings demonstrate a common histogenesis of the two components and support the classification of the neoplasm as a mixed tumor. The patient completely recovered and, 10 months after surgery, head MR confirmed the complete resection of the lesion.
Keywords
Adenoma/pathology, Adenoma/ultrastructure, Adrenocorticotropic Hormone/analysis, Aged, Biomarkers, Tumor/analysis, Chromogranin A/analysis, Craniopharyngioma/pathology, Craniopharyngioma/ultrastructure, Female, Humans, Immunohistochemistry, Mixed Tumor, Malignant/pathology, Mixed Tumor, Malignant/ultrastructure, Pituitary Neoplasms/pathology, Pituitary Neoplasms/ultrastructure, Transcription Factors/analysis, Tumor Suppressor Proteins/analysis
Pubmed
Web of science
Create date
06/09/2016 12:50
Last modification date
20/08/2019 15:54
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