Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma
Histologically, hepatocellular carcinoma (HCC) and atypical pituitary adenoma are similar, posing a potential clinical problem. A 76-year-old woman, whose past medical history was significant for hepatitis C virus (HCV), positivity without liver cirrhosis was presented with abducens nerve (CN VI) pa...
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2019-01-01
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| Series: | Journal of Neurological Surgery Reports |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1685207 |
| _version_ | 1818470304997965824 |
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| author | Hiroyuki Mishima Junichi Ayabe Masahide Watanabe Sota Togin Yuusuke Tsuchiya Taisuke Kawasaki Naoyuki Noda Takumi Maruyama Yoshihide Tanaka |
| author_facet | Hiroyuki Mishima Junichi Ayabe Masahide Watanabe Sota Togin Yuusuke Tsuchiya Taisuke Kawasaki Naoyuki Noda Takumi Maruyama Yoshihide Tanaka |
| author_sort | Hiroyuki Mishima |
| collection | DOAJ |
| description | Histologically, hepatocellular carcinoma (HCC) and atypical pituitary adenoma are similar, posing a potential clinical problem. A 76-year-old woman, whose past medical history was significant for hepatitis C virus (HCV), positivity without liver cirrhosis was presented with abducens nerve (CN VI) palsy. Contrast-enhanced magnetic resonance imaging (MRI) showed a clival tumor with infiltration of the right cavernous sinus. Subtotal resection was performed using a right anterior petrosal approach. Histological diagnosis was pituitary adenoma. Thirty-four days after the operation, MRI imaging showed residual tumor growth without any liver masses on computed tomography (CT). The patient underwent a second operation using an endoscopic transnasal transsphenoidal approach. Histological examination of the specimen gave a positive reaction for α-fetoprotein. Repeat whole-body CT showed an enhanced liver mass. Based on these findings, the lesion was diagnosed as metastatic HCC. The patient died of liver failure 6 months later. In this case, tumor diagnosis was difficult because of the histological similarity of HCC and pituitary adenoma, and the fact that the clival tumor grew prior to presentation of the liver mass on CT. This case emphasizes the importance of comparing the pathological diagnosis with the patient's clinical course. |
| first_indexed | 2024-04-13T21:35:37Z |
| format | Article |
| id | doaj.art-cd7f40140d414d8f84477d40e1d1aebd |
| institution | Directory Open Access Journal |
| issn | 2193-6358 2193-6366 |
| language | English |
| last_indexed | 2024-04-13T21:35:37Z |
| publishDate | 2019-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Neurological Surgery Reports |
| spelling | doaj.art-cd7f40140d414d8f84477d40e1d1aebd2022-12-22T02:28:59ZengGeorg Thieme Verlag KGJournal of Neurological Surgery Reports2193-63582193-63662019-01-018001e18e2210.1055/s-0039-1685207Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary AdenomaHiroyuki Mishima0Junichi Ayabe1Masahide Watanabe2Sota Togin3Yuusuke Tsuchiya4Taisuke Kawasaki5Naoyuki Noda6Takumi Maruyama7Yoshihide Tanaka8Department of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanDepartment of Neurosurgery, Yokosukakyousai Hospital, Yokosukashi, Kanagawaken, JapanHistologically, hepatocellular carcinoma (HCC) and atypical pituitary adenoma are similar, posing a potential clinical problem. A 76-year-old woman, whose past medical history was significant for hepatitis C virus (HCV), positivity without liver cirrhosis was presented with abducens nerve (CN VI) palsy. Contrast-enhanced magnetic resonance imaging (MRI) showed a clival tumor with infiltration of the right cavernous sinus. Subtotal resection was performed using a right anterior petrosal approach. Histological diagnosis was pituitary adenoma. Thirty-four days after the operation, MRI imaging showed residual tumor growth without any liver masses on computed tomography (CT). The patient underwent a second operation using an endoscopic transnasal transsphenoidal approach. Histological examination of the specimen gave a positive reaction for α-fetoprotein. Repeat whole-body CT showed an enhanced liver mass. Based on these findings, the lesion was diagnosed as metastatic HCC. The patient died of liver failure 6 months later. In this case, tumor diagnosis was difficult because of the histological similarity of HCC and pituitary adenoma, and the fact that the clival tumor grew prior to presentation of the liver mass on CT. This case emphasizes the importance of comparing the pathological diagnosis with the patient's clinical course.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1685207clival tumorhepatocellular carcinomaectopic pituitary adenoma α-fetoproteincancer of unknown primary site |
| spellingShingle | Hiroyuki Mishima Junichi Ayabe Masahide Watanabe Sota Togin Yuusuke Tsuchiya Taisuke Kawasaki Naoyuki Noda Takumi Maruyama Yoshihide Tanaka Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma Journal of Neurological Surgery Reports clival tumor hepatocellular carcinoma ectopic pituitary adenoma α-fetoprotein cancer of unknown primary site |
| title | Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma |
| title_full | Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma |
| title_fullStr | Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma |
| title_full_unstemmed | Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma |
| title_short | Clival Metastasis of Hepatocellular Carcinoma with an Initial Histopathological Diagnosis of Atypical Pituitary Adenoma |
| title_sort | clival metastasis of hepatocellular carcinoma with an initial histopathological diagnosis of atypical pituitary adenoma |
| topic | clival tumor hepatocellular carcinoma ectopic pituitary adenoma α-fetoprotein cancer of unknown primary site |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1685207 |
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