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

Elise R Venable; Sarah E Kerr; M Beatriz S Lopes; Karra A Jones; Andrew M Bellizzi; Taofic Mounajjed; Aditya Raghunathan; Oksana Hamidi; Thorvardur R Halfdanarson; Mabel Ryder; Rondell P Graham

doi:10.1186/s13000-020-00997-x

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

Journal article

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Peer reviewed

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

Elise R Venable, Sarah E Kerr, M Beatriz S Lopes, Karra A Jones, Andrew M Bellizzi, Taofic Mounajjed, Aditya Raghunathan, Oksana Hamidi, Thorvardur R Halfdanarson, Mabel Ryder, …

Diagnostic pathology, Vol.15(1), pp.81-81

07/04/2020

DOI: 10.1186/s13000-020-00997-x

PMCID: PMC7335443

PMID: 32622369

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Abstract

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. 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. 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. 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.

Aged

Biomarkers, Tumor - metabolism

Diagnosis, Differential

Female

Humans

Liver Neoplasms - diagnosis

Liver Neoplasms - secondary

Male

Middle Aged

Neuroendocrine Tumors - diagnosis

Pituitary Neoplasms - diagnosis

Pituitary Neoplasms - secondary

Details

Title: Subtitle: Liver metastases from pituitary carcinomas mimicking visceral well-differentiated neuroendocrine tumors: a series of four cases
Creators: Elise R Venable - Mayo Clinic
Sarah E Kerr - Mayo Clinic
M Beatriz S Lopes - University of Virginia
Karra A Jones - University of Iowa
Andrew M Bellizzi - University of Iowa
Taofic Mounajjed - Mayo Clinic
Aditya Raghunathan - Mayo Clinic
Oksana Hamidi - Southwestern Medical Center
Thorvardur R Halfdanarson - Mayo Clinic
Mabel Ryder - Mayo Clinic
Rondell P Graham - Mayo Clinic
Resource Type: Journal article
Publication Details: Diagnostic pathology, Vol.15(1), pp.81-81
DOI: 10.1186/s13000-020-00997-x
PMID: 32622369
PMCID: PMC7335443
NLM abbreviation: Diagn Pathol
ISSN: 1746-1596
eISSN: 1746-1596
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 07/04/2020
Academic Unit: Pathology
Record Identifier: 9984184002902771

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