4.4 Article

Multiple endocrine neoplasia type 1-associated thyrotropin-producing pituitary carcinoma: report of a probable de novo example

Journal

HUMAN PATHOLOGY
Volume 40, Issue 2, Pages 270-278

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.humpath.2008.06.013

Keywords

Pituitary; TSH cell carcinoma; De novo malignancy; Plurihormonality; Ultrastructure; MEN-1 syndrome

Categories

Funding

  1. Mitsubishi Company, Tokyo, Japan
  2. Lloyd-Carr-Harris Foundation

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Pituitary carcinomas are exceedingly rare. At present, the sole diagnostic criterion is metastatic spread, either craniospinal or systemic. There is no agreement oil a histologic, immunohistochemical, and/or Ultrastructural definition. We report a clinically and morphologically well-documented example of pituitary thyrotropin cell carcinoma in a man with multiple endocrine neoplasia type I syndrome. The tumor produced thyrotropin, a-subunit, and prolactin and, through electron microscopy, was found to consist solely of Thyrotroph cells. Over a protracted course, craniospinal and systemic metastases were noted. The primary and metastatic deposits of this aggressive tumor were studied. To our knowledge, this tumor is the first reported case of thyrotropin cell carcinoma occurring in association with the multiple endocrine neoplasia type I syndrome. The literature regarding thyrotropin carcinomas is reviewed. Based on the study of several biopsies during disease progression, we believe that the carcinoma originated de novo without an intermediary adenoma phase. (C) 2009 Elsevier Inc. All rights reserved.

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