TITLE:
Pituicytoma Associated with Serum Adrenocorticotropic Hormone Elevation
AUTHORS:
Issei Fukui, Yasuhiko Hayashi, Iku Nambu, Mitsutoshi Nakada
KEYWORDS:
Pituicytoma, Adrenocorticotropic Hormone, Transsphenoidal Surgery
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.6 No.4,
October
18,
2016
ABSTRACT: Background: Pituicytoma is a rare
benign tumor of the neurohypophysis or hypophyseal stalk. Endocrinological
abnormalities derived from this tumor are even rarer. Although three cases of
pituicytoma with elevated plasma adrenocorticotropic hormone (ACTH) have been
reported previously, the etiological mechanisms remain unknown. Case
Description: We present a 47-year-old
woman who was referred to a hospital complaining of headache. On investigation
using magnetic resonance imaging (MRI), a tumor was detected in the sellar
region. Elevation of basal ACTH and serum cortisol was identified, suggesting
an ACTH-producing pituitary adenoma. However, physical findings and results of
other hormonal examination showed no evidence of Cushing disease. The tumor had
been detected incidentally eight years earlier when MRI was performed, and
showed considerable enlargement on this consultation. Endoscopic endonasal transsphenoidal surgery
was performed in order to remove the tumor completely. The histopathological
diagnosis was pituicytoma. The patient’s postoperative clinical course was
excellent, and both ACTH and cortisol levels returned to normal following
surgery. Conclusions: It appears that ACTH was
being secreted from the tumor cells. We discuss the possible mechanism of ACTH
elevation in cases of pituicytoma.