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Ectopic GH-secreting pituitary adenoma of the clivus: systematic literature review of a challenging tumour
- Source :
- Pituitary. 23:457-466
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Acromegaly is usually due to growth hormone (GH)-secreting pituitary adenomas, but it may be exceptionally caused by GH-secreting ectopic pituitary adenomas (EPA). EPA are defined as extra-sellar pituitary tumours, extra- or intra-cranially sited, entirely separated from the pituitary stalk and gland. The aim of the study is to address the challenges in the management of clival GHEPA. We reported a case of a 53-year-old acromegalic patient with a primary clival GHEPA and reviewed systematically the relevant English literature between 1975 and 2019, in keeping with the PRISMA guidelines. Four cases of primary clival GHEPA have been described in literature apart from ours. All patients presented with acromegalic features, elevated circulating GH and/or insulin-like growth factor-1 levels. Hyperprolactinemia and empty sella were described in two cases, respectively. These tumours show the typical imaging characteristics of pituitary adenomas, but their neuroradiological diagnosis may be challenging due to their sizes and the difficulty in defining the absence of connections with the pituitary fossa. Although primary clival GHEPA are exceedingly rare, even if likely under-reported in literature, they should be considered in the differential diagnosis of clival tumours because of their specific management. Surgery represents the first-line treatment option, while medical and radiation therapies can be adopted as neo-adjuvant, adjuvant or primary treatments according to tumour and patient characteristics.
- Subjects :
- Adenoma
Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
030209 endocrinology & metabolism
Posterior
Choristoma
Growth hormone-secreting adenoma
Growth hormone
Skull Base Neoplasms
Ectopic pituitary adenoma
Cranial Fossa
Clival tumours
03 medical and health sciences
0302 clinical medicine
Endocrinology
Clivus
Acromegaly
medicine
Humans
Insulin-Like Growth Factor I
Pituitary stalk
GH-Secreting Pituitary Adenoma
Human Growth Hormone
business.industry
Empty Sella Syndrome
Glucose Tolerance Test
Middle Aged
medicine.disease
medicine.anatomical_structure
Systematic review
Cranial Fossa, Posterior
Pituitary Gland
Rare tumours
Radiology
Growth Hormone-Secreting Pituitary Adenoma
Bone Diseases
Differential diagnosis
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15737403 and 1386341X
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Pituitary
- Accession number :
- edsair.doi.dedup.....8ee5b92e767b2f2990893a28264a9b65