Liver metastases from pituitary carcinomas mimicking visceral well-differentiated neuroendocrine tumors: a series of four cases.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Venable, ER; Kerr, SE; Lopes, MBS; Jones, KA; Bellizzi, AM; Mounajjed, T; Raghunathan, A; Hamidi, O; Halfdanarson, TR; Ryder, M; Graham, RP

Published Date

  • July 4, 2020

Published In

Volume / Issue

  • 15 / 1

Start / End Page

  • 81 -

PubMed ID

  • 32622369

Pubmed Central ID

  • PMC7335443

Electronic International Standard Serial Number (EISSN)

  • 1746-1596

Digital Object Identifier (DOI)

  • 10.1186/s13000-020-00997-x

Language

  • eng

Conference Location

  • England