Pituitary carcinoma recurrent to the lumbar intradural extramedullary space: Case report

Paul M. Arnold, Denesh Ratnasingam, Maura F. O'Neil, Philip L. Johnson

Research output: Contribution to journalArticle

Abstract

Context: Pituitary tumors are rare, and pituitary carcinomas are rarer still. Prognosis is poor, with less than 50% of patients surviving past 1 year after diagnosis. In this case of spinal metastasis from an adrenocorticotropic hormone-secreting pituitary carcinoma, the intradural extramedullary metastases recurred in the same lumbar area 6 years apart. Findings: Fourteen years prior to presentation in our clinic, a 48-year-old woman was diagnosed with pituitary adenoma which was treated with resection followed by radiation. Eight years later, an intradural extramedullary spinal drop metastasis at L2-L3 was again treated with resection and radiation. Three years later, magnetic resonance imaging (MRI) revealed a mass encasing the right carotid artery, which was treated for 1 year with chemotherapy using temozolomide (Temodar). Three years later, MRI showed intradural extramedullary metastases at the L3-L4 intervertebral disc space and behind the L3 vertebral body; treatment was again resection followed by radiation. Back pain and weakness resolved after surgery and her neurological examination returned to baseline. There was no evidence of recurrence 1 year after surgery. Conclusion/clinical relevance: In this unusual case, this pituitary carcinoma metastasized twice in 6 years to virtually the same intradural extramedullary lumbar region. Surgical resection of these masses aided in relieving neurological symptoms and prolonging life.

Original languageEnglish (US)
Pages (from-to)118-121
Number of pages4
JournalJournal of Spinal Cord Medicine
Volume35
Issue number2
DOIs
StatePublished - Mar 1 2012
Externally publishedYes

Keywords

  • Disc, intervertebral, L3-L4
  • Metastases, neoplasm
  • Pituitary adenoma, ACTH-secreting
  • Pituitary carcinoma
  • Spinal cord neoplasms, intradural-extramedullary, L2-L3

ASJC Scopus subject areas

  • Clinical Neurology

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