Aggressive Pituitary Tumor with Crooke's Cells and Invasion of the Posterior Fossa

World Neurosurg. 2020 Jun:138:530-534.e1. doi: 10.1016/j.wneu.2020.02.137. Epub 2020 Mar 4.

Abstract

Background: Pituitary adenomas are mostly benign in character and are managed via a transsphenoidal approach in most cases. Crooke's cell adenoma (CCA) is a particular variant accounting for less than 1% of the pituitary adenomas. They have a distinctive histopathologic pattern and behavior.

Case description: We present a case of a 56-year-old man with recurrent pituitary adenoma and complicated neurosurgical history. Imaging follow-up showed a suprasellar mass with progressive growth into the posterior fossa. Surgical management via retrosigmoid craniectomy was performed, and histopathology elucidated Crooke's cells.

Conclusions: CCA is recognized by its local aggressiveness and high recurrence rates. They tend to be locally invasive; however, posterior fossa invasion has not been reported to date. We aim to contribute to the arsenal of differential diagnosis of similar pituitary tumor cases.

Keywords: Crooke's cells; Crooke's cells tumor; Pituitary adenoma; Posterior fossa invasion; Skull base; Transsphenoidal.

Publication types

  • Case Reports

MeSH terms

  • ACTH-Secreting Pituitary Adenoma / diagnostic imaging
  • ACTH-Secreting Pituitary Adenoma / pathology
  • ACTH-Secreting Pituitary Adenoma / surgery*
  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Adenoma / surgery*
  • Cranial Fossa, Posterior / diagnostic imaging
  • Cranial Fossa, Posterior / surgery*
  • Craniotomy
  • Disease Progression
  • Hormone Replacement Therapy
  • Humans
  • Hypopituitarism / drug therapy*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neurosurgical Procedures*
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / drug therapy*
  • Watchful Waiting

Supplementary concepts

  • Combined Pituitary Hormone Deficiency