Pediatric silent corticotroph pituitary adenoma and role for proton therapy: case report

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Tumors involving the sella are commonly craniopharyngiomas, optic pathway gliomas, or pituitary adenomas. Functioning adenomas are expected, with prolactinomas topping the differential. The authors present the case of a silent corticotroph adenoma, which has not been described in the pediatric population, and they detail the use of proton therapy, which is also novel.

ABBREVIATIONS ACTH = adrenocorticotrophic hormone; CTV = clinical target volume; EVD = external ventricular drain; FSH = follicle-stimulating hormone; GH = growth hormone; IGF-1 = insulin-like growth factor–1; NFA = nonfunctioning adenoma; RT = radiation therapy; SCA = silent corticotroph adenoma.

Article Information

Correspondence Alexandra D. Beier: UF Health, Jacksonville, FL.

INCLUDE WHEN CITING Published online November 16, 2019; DOI: 10.3171/2018.9.PEDS18107.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.



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    Coronal (left) and sagittal (right) MR images with contrast revealing an enhancing sellar and suprasellar mass.

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    Precontrast (left) and postcontrast (right) sagittal MR images demonstrating subtotal resection of a pituitary adenoma.

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    Left: Reticulin staining revealed a decreased reticulin network. Original magnification × 20. Right: Silent corticotroph adenoma. H & E staining revealed a monomorphic population of pituitary cells. Original magnification × 10. Figure is available in color online only.

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    Postoperative coronal MR image depicting residual disease (arrow) in the right cavernous sinus. Figure is available in color online only.

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    Axial (left) and coronal (right) representative dose distributions for a passively scattered 3D conformal proton therapy plan. Figure is available in color online only.

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    Post–proton therapy coronal MR image revealing stable minimal residual right cavernous sinus disease.



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