{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:17:46Z","timestamp":1774012666425,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 68-year-old Chinese man was found to have a lobular mass in the sphenoid sinus which extended to the clivus and the roof of the nasopharynx on a staging MRI scan performed for his high-grade parotid salivary duct carcinoma. Further positron emission tomography scan showed that this lesion was fluorodeoxyglucose (FDG) avid. This proved to be a diagnostic dilemma. The patient underwent a total parotidectomy, left selective neck dissection and a transphenoidal biopsy of his nasal lesion. Final histology revealed that this lesion was a synchronous ectopic sphenoid sinus pituitary adenoma (ESSPA). Initial differential diagnoses that were considered included a chordoma, metastatic carcinoma and nasopharyngeal carcinoma. However, an important differential with a neoplastic appearance and a tendency for positive FDG uptake is an ESSPA. It requires dedicated immunohistochemical staining to diagnose, and its mainstay of treatment is surgical excision.<\/jats:p>","DOI":"10.1136\/bcr-2020-240411","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T11:56:57Z","timestamp":1615377417000},"page":"e240411","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Ectopic sphenoid sinus pituitary adenoma masquerading as metastatic head and neck cancer"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0358-3753","authenticated-orcid":false,"given":"Augustine","family":"Chai","sequence":"first","affiliation":[{"name":"Otorhinolaryngology, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvin Yong Quan","family":"Soon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3333-1565","authenticated-orcid":false,"given":"Bundele","family":"Manish","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian Li","family":"Tan","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Tan Tock Seng Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"2025082801075508000_14.3.e240411.1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jasc.2018.02.002","article-title":"The Milan system for reporting salivary gland cytopathology (MSRSGC): an ASC-IAC-sponsored system for reporting salivary gland fine-needle aspiration","volume":"7","author":"Rossi","year":"2018","journal-title":"J Am Soc Cytopathol"},{"key":"2025082801075508000_14.3.e240411.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(00)00171-3"},{"key":"2025082801075508000_14.3.e240411.3","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1002\/alr.22023","article-title":"Isolated sphenoid sinus opacifications: a systematic review and meta-analysis","volume":"7","author":"Moss","year":"2017","journal-title":"Int Forum Allergy Rhinol"},{"key":"2025082801075508000_14.3.e240411.4","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1002\/lary.1979.89.8.1239","article-title":"Metastatic tumors to the sphenoid sinus","volume":"89","author":"Barrs","year":"1979","journal-title":"Laryngoscope"},{"key":"2025082801075508000_14.3.e240411.5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/MOO.0b013e32834251d6","article-title":"Isolated sphenoid sinus disease: differential diagnosis and management","volume":"19","author":"Ng","year":"2011","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"2025082801075508000_14.3.e240411.6","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20412"},{"key":"2025082801075508000_14.3.e240411.7","doi-asserted-by":"crossref","first-page":"4014","DOI":"10.1245\/s10434-015-4454-y","article-title":"Distant metastases in patients with carcinoma of the major salivary glands","volume":"22","author":"Ali","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"2025082801075508000_14.3.e240411.8","doi-asserted-by":"publisher","DOI":"10.1080\/00016480500401035"},{"key":"2025082801075508000_14.3.e240411.9","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1177\/0194599818821862","article-title":"Clinical implications of incidental sinonasal positive FDG uptake on PET-CT","volume":"160","author":"Tzelnick","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2025082801075508000_14.3.e240411.10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11102-010-0253-4","article-title":"Demographic differences in incidence for pituitary adenoma","volume":"14","author":"McDowell","year":"2011","journal-title":"Pituitary"},{"key":"2025082801075508000_14.3.e240411.11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s12105-012-0336-9","article-title":"Ectopic sphenoid sinus pituitary adenoma (ESSPA) with normal anterior pituitary gland: a clinicopathologic and immunophenotypic study of 32 cases with a comprehensive review of the English literature","volume":"6","author":"Thompson","year":"2012","journal-title":"Head Neck Pathol"},{"key":"2025082801075508000_14.3.e240411.12","unstructured":"Wenig BM , Heffess CS , Adair CF . Ectopic pituitary adenomas (EPA): a clinicopathologic study of 15 cases. Mod Pathol 1995;8."},{"key":"2025082801075508000_14.3.e240411.13","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/76663418"},{"key":"2025082801075508000_14.3.e240411.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-8389(05)70081-6"},{"key":"2025082801075508000_14.3.e240411.15","doi-asserted-by":"publisher","DOI":"10.1007\/BF00588720"},{"key":"2025082801075508000_14.3.e240411.16","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3904\/kjim.2013.28.1.81","article-title":"Analysis of 18F-fluorodeoxyglucose positron emission tomography findings in patients with pituitary lesions","volume":"28","author":"Seok","year":"2013","journal-title":"Korean J Intern Med"},{"key":"2025082801075508000_14.3.e240411.17","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510400217"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:08:06Z","timestamp":1756368486000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,10]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-240411"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240411","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}