{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:37:13Z","timestamp":1790980633743,"version":"4.1.0"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>Ectopic pituitary adenomas are exceedingly rare entities that are often misdiagnosed. The resulting delay in diagnosis may be particularly concerning in the case of Cushing syndrome caused by an ectopic adrenocorticotropic hormone (ACTH)\u2013secreting pituitary adenoma. Although the total resection of ectopic adenomas results in rapid and durable remission, persistent Cushing syndrome is often associated with permanently damaging invasive procedures and significantly higher risk of mortality.<\/jats:p>\n                  <jats:p>The authors report the case of a 48-year-old man with ACTH-dependent Cushing syndrome. On the morning before surgery, his serum cortisol measured 51 \u03bcg\/dl, his ACTH level was 195.7 pg\/ml, and his urinary free cortisol level was 2109 \u03bcg\/day. Serum cortisol was not suppressed with the administration of high-dose dexamethasone. Imaging showed separate masses in both the sphenoid sinus and the pituitary gland, complicating the diagnostic process and requiring pathological assessment of both masses. No other abnormalities were found on thoracic, abdominal, or pelvic scans. Gross-total resection of both lesions was accomplished via an endoscopic endonasal transsphenoidal approach. Pathology confirmed an ectopic ACTH pituitary adenoma of the sphenoid sinus and a Crooke hyaline change of the pituitary gland. The patient achieved stable hormonal remission without significant postoperative complications, returned to full activity within 3 months, and remained disease free nearly 1 year after tumor resection.<\/jats:p>\n                  <jats:p>In a systematic literature review, the authors identified 41 cases of ectopic ACTH-secreting pituitary adenomas, including 18 arising in the sphenoid sinus without direct involvement of the sella. Including the case described here, the total number of ectopic ACTH pituitary adenomas arising in the sphenoid sinus was 19, and the total number of ectopic ACTH pituitary adenomas without regard to location was 42. For the 19 patients with adenomas found in the sphenoid sinus, ages ranged from 16 to 76 years, and there were 15 women and 4 men. The mean and median diameters of the resected sphenoid masses were 13.9 and 8 mm, respectively, with a range of 3\u201355 mm. Seven were microadenomas (&lt; 1 cm). Fifteen of the 19 cases reported serum ACTH and morning cortisol levels, the means of which were 106.7 pg\/ml and 32.5 \u03bcg\/dl, respectively. Gross-total tumor resection was achieved in all patients except one, and in all of them durable hormonal remission of Cushing syndrome was achieved (mean follow-up time 20 months).<\/jats:p>\n                  <jats:p>Ectopic pituitary adenomas are rare but important causes of Cushing syndrome and related endocrinopathies, particularly because of the rapid onset and severity of symptoms with atypical presentation. Ectopic pituitary adenomas, especially those in the nasal cavity, nasopharynx, or paranasal sinuses, are easily misidentified. Any patient presenting with signs and symptoms of Cushing syndrome without any obvious pituitary adenoma or other sources of hypercortisolemia should be thoroughly screened for an ectopic adenoma. However, as with the case presented here, the coincident existence of a sellar mass should not preclude the possibility of an ectopic source. There should be a high degree of clinical suspicion for any mass in the general area surrounding the sella when evaluating Cushing syndrome.<\/jats:p>","DOI":"10.3171\/2014.10.focus14685","type":"journal-article","created":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T03:40:53Z","timestamp":1422762053000},"page":"E10","source":"Crossref","is-referenced-by-count":33,"title":["Ectopic ACTH-secreting pituitary adenoma of the sphenoid sinus: case report of endoscopic endonasal resection and systematic review of the literature"],"prefix":"10.3171","volume":"38","author":[{"given":"Justin","family":"Seltzer","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Lucas","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Commins","sequence":"additional","affiliation":[{"name":"Pathology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Lerner","sequence":"additional","affiliation":[{"name":"Providence Saint Joseph Medical Center, Burbank, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Lerner","sequence":"additional","affiliation":[{"name":"Radiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Keck School of Medicine of USC, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14685","series-title":"J Neurosurg","first-page":"891","article-title":"Juxtaposition of an ectopic corticotroph adenoma of the sphenoid sinus with orthotopic intrasellar corticotroph hyperplasia in a patient with Cushing disease. Case report","volume":"98","author":"Al-Gahtany","year":"2003"},{"key":"b2-focus14685","series-title":"Endocrinol Metab Clin North Am","first-page":"705","article-title":"Cushing's disease","volume":"16","author":"Aron","year":"1987"},{"key":"b3-focus14685","series-title":"Nat Rev Cancer","first-page":"836","article-title":"The pathogenesis of pituitary tumours","volume":"2","author":"Asa","year":"2002"},{"key":"b4-focus14685","series-title":"Bull Johns Hopkins Hosp","first-page":"137","article-title":"The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)","volume":"50","author":"Cushing","year":"1932"},{"key":"b5-focus14685","series-title":"Clin Endocrinol (Oxf)","first-page":"809","article-title":"Cushing's syndrome due to an ectopic ACTH-secreting pituitary tumour mimicking occult paraneoplastic ectopic ACTH production","volume":"51","author":"Bethge","year":"1999"},{"key":"b6-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"23","article-title":"Two unusual variants of Nelson's syndrome","volume":"49","author":"Bonner","year":"1979"},{"key":"b7-focus14685","series-title":"N Engl J Med","first-page":"587","article-title":"Cushing's disease caused by an ectopic pituitary adenoma within the sphenoid sinus","volume":"312","author":"Burch","year":"1985"},{"key":"b8-focus14685","series-title":"Endocr Pathol","first-page":"65","article-title":"Cushing's syndrome from an ectopic pituitary adenoma with peliosis: a histological, immunohistochemical, and ultrastructural study and review of the literature","volume":"8","author":"Coire","year":"1997"},{"key":"b9-focus14685","series-title":"Neurosurgery","first-page":"529","article-title":"Functioning ectopic supradiaphragmatic pituitary adenomas","volume":"34","author":"Dyer","year":"1994"},{"key":"b10-focus14685","series-title":"Sitz Beitr Path Anat","first-page":"233","article-title":"\u00dcber einen Hypophysen-Tumor von ungew\u00f6hnlichem","volume":"46","author":"Erdheim","year":"1909"},{"key":"b11-focus14685","series-title":"J Laryngol Otol","first-page":"565","article-title":"Ectopic pituitary adenoma in the sphenoid causing Nelsons's syndrome","volume":"111","author":"Esteban","year":"1997"},{"key":"b12-focus14685","series-title":"Pituitary","article-title":"A pitfall in diagnosing Cushing's disease: ectopic ACTH-producing pituitary adenoma in the sphenoid sinus","author":"Flitsch","year":"2014"},{"key":"b13-focus14685","series-title":"Ann Intern Med","first-page":"647","article-title":"Selective venous sampling for ACTH in Cushing's syndrome: differentiation between Cushing disease and the ectopic ACTH syndrome","volume":"94","author":"Findling","year":"1981"},{"key":"b14-focus14685","series-title":"Pituitary","first-page":"423","article-title":"Nasally located ectopic ACTH-secreting pituitary adenoma (EAPA) causing Nelson's syndrome: diagnostic challenges","volume":"17","author":"Gurazada","year":"2014"},{"key":"b15-focus14685","series-title":"J Comput Assist Tomogr","first-page":"424","article-title":"Case report: Cushing disease caused by an ectopic intracavernous pituitary microadenoma: case report and review of the literature","volume":"27","author":"Hamon","year":"2003"},{"key":"b16-focus14685","series-title":"Neurosurgery","first-page":"618","article-title":"Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature review","volume":"50","author":"Hou","year":"2002"},{"key":"b17-focus14685","series-title":"Endocrine","first-page":"717","article-title":"Ectopic ACTH-secreting pituitary adenomas within the sphenoid sinus","volume":"47","author":"Johnston","year":"2014"},{"key":"b18-focus14685","series-title":"Pathol Int","first-page":"901","article-title":"Supradiaphragmatic ectopic adrenocorticotropic hormonesecreting adenoma","volume":"50","author":"Jung","year":"2000"},{"key":"b19-focus14685","series-title":"JAMA","first-page":"2722","article-title":"Cushing's disease in a patient with an ectopic pituitary adenoma","volume":"246","author":"Kammer","year":"1981"},{"key":"b20-focus14685","series-title":"J Neurosurg","first-page":"1312","article-title":"Ectopic intracavernous sinus adrenocorticotropic hormone-secreting microadenoma: could this be a common cause of failed transsphenoidal surgery in Cushing disease? Case report","volume":"98","author":"Kim","year":"2003"},{"key":"b21-focus14685","series-title":"Pituitary","first-page":"295","article-title":"Successful treatment of Cushing's disease caused by ectopic intracavernous microadenoma","volume":"14","author":"Koizumi","year":"2011"},{"key":"b22-focus14685","series-title":"Ann Otol Rhinol Laryngol","first-page":"167","article-title":"Pituitary gland involvement of the sinonasal tract","volume":"104","author":"Langford","year":"1995"},{"key":"b23-focus14685","series-title":"Clin Neuropathol","first-page":"138","article-title":"ACTH and TSH producing ectopic suprasellar pituitary adenoma of the hypothalamic region: case report","volume":"12","author":"Lindboe","year":"1993"},{"key":"b24-focus14685","series-title":"Neurosurgery","first-page":"681","article-title":"Suprasellar ectopic pituitary adenoma: case report and review of the literature","volume":"26","author":"Matsumura","year":"1990"},{"key":"b25-focus14685","series-title":"Endocr Pathol","first-page":"123","article-title":"Cushing's syndrome caused by an ectopic pituitary adenoma of the sphenoid sinus: adrenal crisis after partial resections of the adenoma","volume":"5","author":"Morita","year":"1994"},{"key":"b26-focus14685","series-title":"Endocr J","first-page":"631","article-title":"Supra- and extrasellar pituitary microadenoma as a cause of Cushing's disease","volume":"45","author":"Murakami","year":"1998"},{"key":"b27-focus14685","series-title":"Lancet","first-page":"1605","article-title":"Cushing's syndrome","volume":"367","author":"Newell-Price","year":"2006"},{"key":"b28-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"1526","article-title":"The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman","year":"2008"},{"key":"b29-focus14685","series-title":"J Neurosurg","first-page":"437","article-title":"Pituitary adenomas of adolescents","volume":"43","author":"Ortiz-Suarez","year":"1975"},{"key":"b30-focus14685","series-title":"Eur J Endocrinol","first-page":"209","article-title":"Favorable long-term outcomes of bilateral adrenalectomy in Cushing's disease","volume":"171","author":"O\u00dfwald","year":"2014"},{"key":"b31-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"2912","article-title":"Extrapituitary parasellar microadenoma in Cushing's disease","volume":"84","author":"Pluta","year":"1999"},{"key":"b32-focus14685","series-title":"Endocrine Abstracts","first-page":"P1458","article-title":"Pitfalls in Cushing's disease: report of an ectopic ACTH-producing pituitary adenoma in the sphenoid sinus","volume":"29","author":"Ritter","year":"2012"},{"key":"b33-focus14685","series-title":"Neurosurgery","first-page":"914","article-title":"Ectopic corticotroph adenoma in the cavernous sinus: case report","volume":"45","author":"Sanno","year":"1999"},{"key":"b34-focus14685","series-title":"Neurosurgery","first-page":"223","article-title":"Cushing's syndrome caused by an ectopic pituitary adenoma","volume":"21","author":"Schteingart","year":"1987"},{"key":"b35-focus14685","series-title":"Neuroradiology","first-page":"546","article-title":"MRI appearances of an ectopic pituitary adenoma: case report and review of the literature","volume":"35","author":"Slonim","year":"1993"},{"key":"b36-focus14685","series-title":"JPMS","first-page":"59","article-title":"Sphenoidal ectopic ACTH-secreting pituitary adenoma","volume":"2","author":"Srikantha","year":"2012"},{"key":"b37-focus14685","series-title":"Endocr J","first-page":"97","article-title":"An aberrant ACTH-producing ectopic pituitary adenoma in the sphenoid sinus","volume":"51","author":"Suzuki","year":"2004"},{"key":"b38-focus14685","series-title":"J Neurosurg","first-page":"1092","article-title":"Ectopic pituitary adenoma occurring in the interpeduncular cistern. Case report","volume":"83","author":"Takahata","year":"1995"},{"key":"b39-focus14685","series-title":"South Med J","first-page":"249","article-title":"Cushing's disease caused by ectopic pituitary adenoma within the pituitary stalk","volume":"86","author":"Tal","year":"1993"},{"key":"b40-focus14685","series-title":"Head Neck Pathol","first-page":"75","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"},{"key":"b41-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"384","article-title":"An unusual case of ectopic adrenocorticotropin secretion","volume":"94","author":"Trulea","year":"2009"},{"key":"b42-focus14685","series-title":"Laryngoscope","first-page":"1132","article-title":"Detection of paranasal ectopic adrenocorticotropic hormone-secreting pituitary adenoma by Ga-68-DOTANOC positron-emission tomography-computed tomography","volume":"123","author":"Veit","year":"2013"},{"key":"b43-focus14685","series-title":"Exp Clin Endocrinol Diabetes","first-page":"63","article-title":"An unusual case of ectopic ACTH syndrome","volume":"120","author":"Willhauck","year":"2012"},{"key":"b44-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"1774","article-title":"Extrasellar, intracavernous sinus adrenocorticotropin-releasing adenoma causing Cushing's disease","volume":"80","author":"Wilson","year":"1995"},{"key":"b45-focus14685","series-title":"Nat Clin Pract Endocrinol Metab","first-page":"174","article-title":"Cyclic Cushing syndrome due to an ectopic pituitary adenoma","volume":"5","author":"Zerikly","year":"2009"},{"key":"b1-focus14685","series-title":"J Neurosurg","first-page":"891","article-title":"Juxtaposition of an ectopic corticotroph adenoma of the sphenoid sinus with orthotopic intrasellar corticotroph hyperplasia in a patient with Cushing disease. Case report","volume":"98","author":"Al-Gahtany","year":"2003"},{"key":"b2-focus14685","series-title":"Endocrinol Metab Clin North Am","first-page":"705","article-title":"Cushing's disease","volume":"16","author":"Aron","year":"1987"},{"key":"b3-focus14685","series-title":"Nat Rev Cancer","first-page":"836","article-title":"The pathogenesis of pituitary tumours","volume":"2","author":"Asa","year":"2002"},{"key":"b4-focus14685","series-title":"Bull Johns Hopkins Hosp","first-page":"137","article-title":"The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)","volume":"50","author":"Cushing","year":"1932"},{"key":"b5-focus14685","series-title":"Clin Endocrinol (Oxf)","first-page":"809","article-title":"Cushing's syndrome due to an ectopic ACTH-secreting pituitary tumour mimicking occult paraneoplastic ectopic ACTH production","volume":"51","author":"Bethge","year":"1999"},{"key":"b6-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"23","article-title":"Two unusual variants of Nelson's syndrome","volume":"49","author":"Bonner","year":"1979"},{"key":"b7-focus14685","series-title":"N Engl J Med","first-page":"587","article-title":"Cushing's disease caused by an ectopic pituitary adenoma within the sphenoid sinus","volume":"312","author":"Burch","year":"1985"},{"key":"b8-focus14685","series-title":"Endocr Pathol","first-page":"65","article-title":"Cushing's syndrome from an ectopic pituitary adenoma with peliosis: a histological, immunohistochemical, and ultrastructural study and review of the literature","volume":"8","author":"Coire","year":"1997"},{"key":"b9-focus14685","series-title":"Neurosurgery","first-page":"529","article-title":"Functioning ectopic supradiaphragmatic pituitary adenomas","volume":"34","author":"Dyer","year":"1994"},{"key":"b10-focus14685","series-title":"Sitz Beitr Path Anat","first-page":"233","article-title":"\u00dcber einen Hypophysen-Tumor von ungew\u00f6hnlichem","volume":"46","author":"Erdheim","year":"1909"},{"key":"b11-focus14685","series-title":"J Laryngol Otol","first-page":"565","article-title":"Ectopic pituitary adenoma in the sphenoid causing Nelsons's syndrome","volume":"111","author":"Esteban","year":"1997"},{"key":"b12-focus14685","series-title":"Pituitary","article-title":"A pitfall in diagnosing Cushing's disease: ectopic ACTH-producing pituitary adenoma in the sphenoid sinus","author":"Flitsch","year":"2014"},{"key":"b13-focus14685","series-title":"Ann Intern Med","first-page":"647","article-title":"Selective venous sampling for ACTH in Cushing's syndrome: differentiation between Cushing disease and the ectopic ACTH syndrome","volume":"94","author":"Findling","year":"1981"},{"key":"b14-focus14685","series-title":"Pituitary","first-page":"423","article-title":"Nasally located ectopic ACTH-secreting pituitary adenoma (EAPA) causing Nelson's syndrome: diagnostic challenges","volume":"17","author":"Gurazada","year":"2014"},{"key":"b15-focus14685","series-title":"J Comput Assist Tomogr","first-page":"424","article-title":"Case report: Cushing disease caused by an ectopic intracavernous pituitary microadenoma: case report and review of the literature","volume":"27","author":"Hamon","year":"2003"},{"key":"b16-focus14685","series-title":"Neurosurgery","first-page":"618","article-title":"Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature review","volume":"50","author":"Hou","year":"2002"},{"key":"b17-focus14685","series-title":"Endocrine","first-page":"717","article-title":"Ectopic ACTH-secreting pituitary adenomas within the sphenoid sinus","volume":"47","author":"Johnston","year":"2014"},{"key":"b18-focus14685","series-title":"Pathol Int","first-page":"901","article-title":"Supradiaphragmatic ectopic adrenocorticotropic hormonesecreting adenoma","volume":"50","author":"Jung","year":"2000"},{"key":"b19-focus14685","series-title":"JAMA","first-page":"2722","article-title":"Cushing's disease in a patient with an ectopic pituitary adenoma","volume":"246","author":"Kammer","year":"1981"},{"key":"b20-focus14685","series-title":"J Neurosurg","first-page":"1312","article-title":"Ectopic intracavernous sinus adrenocorticotropic hormone-secreting microadenoma: could this be a common cause of failed transsphenoidal surgery in Cushing disease? Case report","volume":"98","author":"Kim","year":"2003"},{"key":"b21-focus14685","series-title":"Pituitary","first-page":"295","article-title":"Successful treatment of Cushing's disease caused by ectopic intracavernous microadenoma","volume":"14","author":"Koizumi","year":"2011"},{"key":"b22-focus14685","series-title":"Ann Otol Rhinol Laryngol","first-page":"167","article-title":"Pituitary gland involvement of the sinonasal tract","volume":"104","author":"Langford","year":"1995"},{"key":"b23-focus14685","series-title":"Clin Neuropathol","first-page":"138","article-title":"ACTH and TSH producing ectopic suprasellar pituitary adenoma of the hypothalamic region: case report","volume":"12","author":"Lindboe","year":"1993"},{"key":"b24-focus14685","series-title":"Neurosurgery","first-page":"681","article-title":"Suprasellar ectopic pituitary adenoma: case report and review of the literature","volume":"26","author":"Matsumura","year":"1990"},{"key":"b25-focus14685","series-title":"Endocr Pathol","first-page":"123","article-title":"Cushing's syndrome caused by an ectopic pituitary adenoma of the sphenoid sinus: adrenal crisis after partial resections of the adenoma","volume":"5","author":"Morita","year":"1994"},{"key":"b26-focus14685","series-title":"Endocr J","first-page":"631","article-title":"Supra- and extrasellar pituitary microadenoma as a cause of Cushing's disease","volume":"45","author":"Murakami","year":"1998"},{"key":"b27-focus14685","series-title":"Lancet","first-page":"1605","article-title":"Cushing's syndrome","volume":"367","author":"Newell-Price","year":"2006"},{"key":"b28-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"1526","article-title":"The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman","year":"2008"},{"key":"b29-focus14685","series-title":"J Neurosurg","first-page":"437","article-title":"Pituitary adenomas of adolescents","volume":"43","author":"Ortiz-Suarez","year":"1975"},{"key":"b30-focus14685","series-title":"Eur J Endocrinol","first-page":"209","article-title":"Favorable long-term outcomes of bilateral adrenalectomy in Cushing's disease","volume":"171","author":"O\u00dfwald","year":"2014"},{"key":"b31-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"2912","article-title":"Extrapituitary parasellar microadenoma in Cushing's disease","volume":"84","author":"Pluta","year":"1999"},{"key":"b32-focus14685","series-title":"Endocrine Abstracts","first-page":"P1458","article-title":"Pitfalls in Cushing's disease: report of an ectopic ACTH-producing pituitary adenoma in the sphenoid sinus","volume":"29","author":"Ritter","year":"2012"},{"key":"b33-focus14685","series-title":"Neurosurgery","first-page":"914","article-title":"Ectopic corticotroph adenoma in the cavernous sinus: case report","volume":"45","author":"Sanno","year":"1999"},{"key":"b34-focus14685","series-title":"Neurosurgery","first-page":"223","article-title":"Cushing's syndrome caused by an ectopic pituitary adenoma","volume":"21","author":"Schteingart","year":"1987"},{"key":"b35-focus14685","series-title":"Neuroradiology","first-page":"546","article-title":"MRI appearances of an ectopic pituitary adenoma: case report and review of the literature","volume":"35","author":"Slonim","year":"1993"},{"key":"b36-focus14685","series-title":"JPMS","first-page":"59","article-title":"Sphenoidal ectopic ACTH-secreting pituitary adenoma","volume":"2","author":"Srikantha","year":"2012"},{"key":"b37-focus14685","series-title":"Endocr J","first-page":"97","article-title":"An aberrant ACTH-producing ectopic pituitary adenoma in the sphenoid sinus","volume":"51","author":"Suzuki","year":"2004"},{"key":"b38-focus14685","series-title":"J Neurosurg","first-page":"1092","article-title":"Ectopic pituitary adenoma occurring in the interpeduncular cistern. Case report","volume":"83","author":"Takahata","year":"1995"},{"key":"b39-focus14685","series-title":"South Med J","first-page":"249","article-title":"Cushing's disease caused by ectopic pituitary adenoma within the pituitary stalk","volume":"86","author":"Tal","year":"1993"},{"key":"b40-focus14685","series-title":"Head Neck Pathol","first-page":"75","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"},{"key":"b41-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"384","article-title":"An unusual case of ectopic adrenocorticotropin secretion","volume":"94","author":"Trulea","year":"2009"},{"key":"b42-focus14685","series-title":"Laryngoscope","first-page":"1132","article-title":"Detection of paranasal ectopic adrenocorticotropic hormone-secreting pituitary adenoma by Ga-68-DOTANOC positron-emission tomography-computed tomography","volume":"123","author":"Veit","year":"2013"},{"key":"b43-focus14685","series-title":"Exp Clin Endocrinol Diabetes","first-page":"63","article-title":"An unusual case of ectopic ACTH syndrome","volume":"120","author":"Willhauck","year":"2012"},{"key":"b44-focus14685","series-title":"J Clin Endocrinol Metab","first-page":"1774","article-title":"Extrasellar, intracavernous sinus adrenocorticotropin-releasing adenoma causing Cushing's disease","volume":"80","author":"Wilson","year":"1995"},{"key":"b45-focus14685","series-title":"Nat Clin Pract Endocrinol Metab","first-page":"174","article-title":"Cyclic Cushing syndrome due to an ectopic pituitary adenoma","volume":"5","author":"Zerikly","year":"2009"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/38\/2\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/38\/2\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/38\/2\/article-pE10.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:48:09Z","timestamp":1779526089000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/38\/2\/article-pE10.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":90,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2014.10.focus14685","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2]]}}}