Asymptomatic silent giant corticotroph adenoma with invasion of cavernous and sphenoid sinuses in association with dermatomyositis: a case report and literature review

Due to increased incidence of nasopharyngeal carcinoma (NPC) in Asians with dermatomyositis2, nasopharyngoscopy was performed which showed a mass arising from the skull base, replacing the posterior septum, without evidence of NPC. [...]SCAs have higher recurrence rates3 than other non-functioning pituitary adenomas (NFPA), necessitating repeated surgery and chemoradiotherapy. Recurrent SCAs are larger and stain more strongly for ACTH.5 Furthermore, NFPA with a higher tendency for secondary therapy after resection had a higher tumour growth rate (>80mm3/year).6 Although only scattered cells were positive for SSTR2, SSTR immunohistochemistry may have prognostic significance as recurrent tumours had a lower level of expression of SSTR5.7 Higher expression of SSTR2 in SCAs could also have implications for treatment.3 This is currently undergoing a phase II randomised controlled trial (PASSILCORT, QinicalTrial.gov identifier, NCT02749227).