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- Title
Liver metastases from pituitary carcinomas mimicking visceral well-differentiated neuroendocrine tumors: a series of four cases.
- Authors
Venable, Elise R.; Kerr, Sarah E.; Lopes, M. Beatriz S.; Jones, Karra A.; Bellizzi, Andrew M.; Mounajjed, Taofic; Raghunathan, Aditya; Hamidi, Oksana; Halfdanarson, Thorvardur R.; Ryder, Mabel; Graham, Rondell P.
- Abstract
Background: Pathologists frequently encounter neuroendocrine tumors (NETs) presenting as multiple liver masses in routine practice. Most often, these are well-differentiated tumors with characteristic histologic features. In contrast, pituitary carcinoma is very rare, and there is limited data on its natural history and pathologic characterization. Methods: The aim of this study was to describe clinical characteristics, histomorphology, immunophenotype and follow-up of pituitary carcinoma involving the liver and mimicking well-differentiated NETs of visceral origin. We selected a group of well-differentiated NETs of the pancreas to use as immunophenotypic controls. We identified 4 patients (age range, 51 to 73) with pituitary corticotroph carcinoma with liver metastases. Three patients presented with Cushing syndrome. Results: All cases histologically resembled well-differentiated NETs of visceral origin with Ki-67 proliferation indices of 5–42% and expression of T-PIT; metastatic tumors were not immunoreactive with CDX2, Islet 1 or TTF-1. Conclusions: Frequently, these cases display adrenocorticotropic hormone (ACTH) secretion and pituitary-specific transcription factor immunohistochemistry may be used as a reliable marker to distinguish metastatic pituitary carcinoma from NETs of visceral origin in addition to delineating a corticotroph carcinoma from somatotroph, lactotroph, thyrotroph, and gonadotroph lineage. Although rare, the differential diagnosis of pituitary carcinoma should be considered in metastatic well-differentiated NETs in which the site of origin is uncertain. In summary, pituitary corticotroph carcinoma can metastasize to the liver and mimic well-differentiated NET.
- Subjects
NEUROENDOCRINE tumors; LIVER metastasis; CARCINOMA; ADRENOCORTICOTROPIC hormone; CUSHING'S syndrome; INSULIN aspart; HISTOCHEMISTRY; PITUITARY hormones
- Publication
Diagnostic Pathology, 2020, Vol 15, Issue 1, p1
- ISSN
1746-1596
- Publication type
Article
- DOI
10.1186/s13000-020-00997-x