CLINICAL AND GENETIC CHANGES IN A CASE OF A CUSHINGS CARCINOMA

A 30-year-old presented in 1984 with a clinically nonfunctional tumour which subsequently developed into a metastatic corticotrophinoma from which he died despite surgery in 1984, 1986 and 1991 and external rad iotherapy in 1986. Molecular genetic analysis of tumour and metastatic tissue revealed loss of heterozygosity at loci on the autosomes 1p, 3 p, 10q26, 11q13 and 22q12. Tissue taken at surgery in 1986 also reveal ed positive cytoplasmic immunostaining for p53 protein. No such staini ng was evident in tissue taken at first surgery in 1984. Further analy sis of invasive pituitary adenomas may reveal loci associated with suc h behaviour, enabling better prediction of subsequent clinical outcome than is possible using standard histological techniques, and delivery of early, aggressive treatment to those tumours which show molecular markers associated with a poor prognosis.