case_images: PMC10754633_01
case_images: (A) Skull X-ray: enlargement of the sella turcica. (B) Skull MRI in T2 and (C) skull MRI in T1: presence of a 3.1 cm lesion invading the pituitary fossa. (D) MRI in T1: infiltrative lesion compromising the bony segments of the skull and face.
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case_images: fig1
case_images: The magnetic resonance imaging (MRI) showed a 3.1 cm contrast-enhanced mass invading the pituitary fossa and causing compression of the optic chiasm (Figure 1).
case_images: Histology of osteoclastoma in sphenoid sinus and parathyroid carcinoma. (a) Proliferation of multinucleated giant cells (osteoclast-like). (b, c) Areas of necrosis, capsule invasion, peripheral adipose tissue and cell pleomorphism. Immunohistochemistry: positive antibodies MRQ-31, Ki-67, galectin-3, and CD31.
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case_images: fig2
case_images: A transsphenoidal biopsy histologically confirmed an osteoclastoma located at the sphenoid bone (Figure 2(a)). In a new surgical approach, nodules located adjacent to the thyroid were excised, with the histopathological examination demonstrating neoplasia consisting of diffuse proliferation and rarely cell nests, mitotic figures, necrosis, capsular, and vascular invasion with emboli (Figures 2(b) and 2(c)).
case_images: MRI in T1 showing significant regression of pituitary fossa lesion one year after parathyroidectomy.
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case_images: fig3
case_images: PTH decreased but remained elevated, with serum calcium reaching levels at the upper limit of normal, characterizing a normocalcemic hyperparathyroidism. Pituitary MRI showed shrinkage of the sphenoid bone osteoclastoma (Figure 3), and new laboratory tests showed normalization of the pituitary corticotroph function (Table 1).