Pituitary Carcinoma: Rare Disease with Difficult Diagnosis and Treatment

Although pituitary tumours are common, pituitary carcinomas are very rare. They are defined as adenohypophyseal tumours with metastatic activity within and outside the boundaries of the central nervous system (CNS). They usually spread to the other parts of the body, by the time they are diagnosed. Because so few cases of pituitary carcinoma have been reported worldwide, it is difficult to learn much about them, and it is difficult to diagnose and treat them. Pituitary carcinomas cannot be distinguished from benign pituitary tumours only on the basis of clinical findings and imaging. Presence of metastases is indicative of carcinoma. Many molecular markers for pathogenesis have been proposed, but none so far is a reliable predictor of disease progression or outcome. Treatment for pituitary carcinomas includes surgery, radiotherapy, and chemotherapy. The paucity of reported cases and literature on pituitary carcinomas renders necessary further research into underlying mechanisms, diagnostic findings, and novel molecular targets for therapy.