Silent adrenocorticotrophic @entity977 are nonfunctioning @entity977 that express adrenocorticotrophic hormone ( @entity4545 ) but do not cause the clinical or laboratory features of hypercortisolemia. Primary central nervous system (CNS) @entity320 is well documented, but rarely originates in the sellar region or pituitary gland. Here we report transformation of an @entity146 silent adrenocorticotrophic pituitary adenoma that transformed into CNS @entity320 and review other presentations of @entity320 . A 37-year-old @entity1 initially presented with apoplexy and an invasive nonfunctioning @entity4611 for which she underwent transphenoidal surgery. The @entity1 underwent 3 subsequent surgeries as the @entity5 continued to progress. Pathology from the first 3 operations showed @entity977 . Pathology from the final surgery showed @entity320 and the magnetic resonance imaging characteristics of the @entity5 had changed to become consistent with CNS @entity320 . Dermatologic and ophthalmologic examinations did not identify cutaneous or @entity320 . The @entity1 's disease progressed despite @entity146 surgical, medical and radiologic treatment. To our knowledge, this is the first report demonstrating transformation of a primary @entity977 into @entity320 . The mechanism of @entity5 transformation is unclear, but it is possible that a mutation in the original @entity4545 -producing @entity5 lead to increased cleavage of @entity4545 or @entity4545 into a-melanocyte-stimulating hormone, which in turn stimulated the expression of microopthalmia transcription factor, leading to melanocytic phenotype transformation.

Transformation of a Silent XXXX Tumor Into Central Nervous System Melanoma.

@entity1 :: ('9606', 'Species') :: ['woman', 'patient'] @entity4545 :: ('5443', 'Gene') :: ['pro-opiomelanocortin', 'ACTH'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressive'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity4611 :: ('MESH:D010900', 'Disease') :: ['pituitary macroadenoma'] @entity977 :: ('MESH:D010911', 'Disease') :: ['pituitary tumor', 'pituitary adenomas', 'pituitary adenoma or carcinoma'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'pituitary melanoma', 'ocular melanoma']
@entity4611 :: (MESH:D010900,Disease) :: ['Adrencorticotrophic Pituitary']
