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Other than pituitary adenomas, tumors present in sellar and suprasellar regions include craniopharyngiomas, germ cell tumors, optic pathway gliomas, hamartomas, dermoids, epidermoids, lipomas, choristomas and metastases. [1] Metastasis to pituitary gland is very rare (1% of all pituitary neoplasms) and presents with similar clinical presentation as pituitary adenoma.[1-3] Mainly lung in men and breast in women are the primary sites for metastasis.[3,4] Radiology is usually not sufficient to differentiate metastatic lesions from pituitary adenomas. [1,2,4,5] In our case, brain MRI depicted a sellar lesion extending to the suprasellar region, enhanced uniformly after intravenous contrast material. There was no necrotic area, ring enhancement or bony erosion. Furthermore, the clinical progress was insidious. She had been operated for breast carcinoma 7 years before this presentation. Histopathology and immunohistochemical studies helped to make the correct diagnosis. MIB-1 value was very high and compatible with metastatic lesion.[2] Immunostaining was strongly positive for pan-cytokeratin and negative for synaptophysin. Pan-cytokeratin suggested the relationship of the current pathology with the previous breast neoplasm. Our case is unique that there was neither a local recurrence nor distant metastasis. Due to suprasellar invasion of the tumor and frozen diagnosis of metastasis, we preferred debulking surgery with post-operative adjuvant stereotactic radiosurgery.
Acknowledgments We thank to Gülcan Davulcu and Ardınç Arpınar for their technical support in preparing the manuscript in this study.
Murat Şakir Ekşi, Teyyub Hasanov1, Baran Yılmaz2, Akın Akakın2, Yaşar Bayri1, Suheyla Uyar Bozkurt3, Türker Kılıç2
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Website: www.neurologyindia.com PMID: *** DOI: 10.4103/0028-3886.128322
Received: 23-01-2014 Review completed: 23-01-2014 Accepted: 25-01-2014
Giant calcified intraventricular pilocytic astrocytoma: A rare entity Sir, Pilocytic astrocytomas (PA) account for about 5-6% of all gliomas. In PA calcifi cation is an infrequent finding. It is extremely rare for an intraventricular PA to present as a calcified mass. [1] We present two cases of giant intraventricular calcified PA. The clinical characteristics, image findings and pathological features of both patients are given in Table 1 [Figures 1-3]. Tumors of the lateral ventricles account for
Other than pituitary adenomas, tumors present in sellar and suprasellar regions include craniopharyngiomas, germ cell tumors, optic pathway gliomas, hamartomas, dermoids, epidermoids, lipomas, choristomas and metastases. [1] Metastasis to pituitary gland is very rare (1% of all pituitary neoplasms) and presents with similar clinical presentation as pituitary adenoma.[1-3] Mainly lung in men and breast in women are the primary sites for metastasis.[3,4] Radiology is usually not sufficient to differentiate metastatic lesions from pituitary adenomas. [1,2,4,5] In our case, brain MRI depicted a sellar lesion extending to the suprasellar region, enhanced uniformly after intravenous contrast material. There was no necrotic area, ring enhancement or bony erosion. Furthermore, the clinical progress was insidious. She had been operated for breast carcinoma 7 years before this presentation. Histopathology and immunohistochemical studies helped to make the correct diagnosis. MIB-1 value was very high and compatible with metastatic lesion.[2] Immunostaining was strongly positive for pan-cytokeratin and negative for synaptophysin. Pan-cytokeratin suggested the relationship of the current pathology with the previous breast neoplasm. Our case is unique that there was neither a local recurrence nor distant metastasis. Due to suprasellar invasion of the tumor and frozen diagnosis of metastasis, we preferred debulking surgery with post-operative adjuvant stereotactic radiosurgery.
Acknowledgments We thank to Gülcan Davulcu and Ardınç Arpınar for their technical support in preparing the manuscript in this study.
Murat Şakir Ekşi, Teyyub Hasanov1, Baran Yılmaz2, Akın Akakın2, Yaşar Bayri1, Suheyla Uyar Bozkurt3, Türker Kılıç2
Access this article online Quick Response Code:
Website: www.neurologyindia.com PMID: *** DOI: 10.4103/0028-3886.128322
Received: 23-01-2014 Review completed: 23-01-2014 Accepted: 25-01-2014
Giant calcified intraventricular pilocytic astrocytoma: A rare entity Sir, Pilocytic astrocytomas (PA) account for about 5-6% of all gliomas. In PA calcifi cation is an infrequent finding. It is extremely rare for an intraventricular PA to present as a calcified mass. [1] We present two cases of giant intraventricular calcified PA. The clinical characteristics, image findings and pathological features of both patients are given in Table 1 [Figures 1-3]. Tumors of the lateral ventricles account for
