Gonadotropic pituitary carcinoma: HER-2/neu expression and gene amplification. Report of two cases

J Neurosurg. 2003 Aug;99(2):402-8. doi: 10.3171/jns.2003.99.2.0402.

Abstract

The authors report on two gonadotropic carcinomas of the adenohypophysis that occurred in a55-year-old man (Case 1) and a 53-year-old woman (Case 2), with signs of mass effect and amenorrhea, respectively. Both lesions were macroadenomas. The tumor in Case 1 metastasized to dura mater, skull, nasal sinus, and larynx 2 years after patient presentation, whereas that in Case 2 spread to vertebral bodies and ribs after a 19-year latency. Histologically, the primary, recurrent, and metastatic lesions in Case 1 featured brisk mitotic activity and high MIB-1 levels as well as p53 labeling indices. Immunoreactivity for HER-2/neu was assessable only in rare neoplastic cells of the second recurrence and in 80% of cells of the dural metastasis. Low-level HER-2/neu gene amplification was evident in the recurrent tumors and metastasis. The sellar and metastatic tumors in Case 2 resembled benign gonadotropic adenoma with oncocytic change; p53 accumulation, HER-2/neu overexpression, and HER-2/neu gene amplification were not present. The results indicate that low-level amplification of the HER-2/neu gene might be associated with pituitary carcinomas in which more aggressive behavior is seen. Further studies are needed to determine whether HER-2/neu plays a role in the pathogenesis of pituitary carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary
  • Carcinoma / genetics*
  • Carcinoma / pathology
  • Dura Mater / diagnostic imaging
  • Dura Mater / pathology
  • Female
  • Gene Amplification / genetics*
  • Genes, erbB-2 / genetics*
  • Gonadotropins / metabolism*
  • Humans
  • In Situ Hybridization, Fluorescence / methods
  • Laryngeal Neoplasms / secondary
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasms
  • Paranasal Sinus Neoplasms / secondary
  • Pituitary Neoplasms / genetics*
  • Pituitary Neoplasms / metabolism*
  • Pituitary Neoplasms / pathology
  • Skull Neoplasms / secondary
  • Tomography, X-Ray Computed

Substances

  • Gonadotropins