Pituitary macroadenoma presenting as a nasal tumor: case report

Sao Paulo Medical Journal

Nivaldo Adolfo Silva Junior¹  Fabiano Reis¹  Larissa Kaori Miura¹  Guilherme Henrique Vieira¹  Luciano Souza Queiroz¹  Heraldo Mendes Garmes¹  Cristina Laguna Benetti-pinto¹ 

关键词: Pituitary neoplasms.;    Nasal cavity;    Growth hormone-secreting pituitary adenoma;    Amenorrhea;    Prolactin;    Neoplasias hipofisárias;    Cavidade nasal;    Adenoma hipofisário secretor de hormônio do crescimento;    Amenorreia;    Prolactina;   

DOI  :  10.1590/1516-3180-2014-1326693

来源: SciELO

【 摘 要 】

CONTEXT: Pituitary macroadenomas are rare intracranial tumors. In a few cases, they may present aggressive behavior and invade the sphenoid sinus and nasal cavity, causing unusual symptoms. In this paper, we report an atypical case of pituitary adenoma presenting as a nasal mass.CASE REPORT: The patient was a 44-year-old woman who had had amenorrhea and galactorrhea for ten months, with associated nasal obstruction, macroglossia and acromegaly. Both growth hormone and prolactin levels were increased. Magnetic resonance imaging showed a large mass originating from the lower surface of the pituitary gland, associated with sella turcica erosion and tumor extension through the sphenoid sinus and nasal cavity. Histopathological analysis demonstrated a chromophobe pituitary adenoma with densely packed rounded epithelial cells, with some atypias and rare mitotic figures. There was no evidence of metastases.CONCLUSION: Macroadenoma invading the nasal cavity is a rare condition and few similar cases have been reported in the literature. This study contributes towards showing that tumor extension to the sphenoid sinus and nasopharynx needs to be considered and investigated in order to make an early diagnosis when atypical symptoms like nasal obstruction are present.

【 授权许可】

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