Metastatic tumours to hypophysis: a report of three cases and review of literature
Background. Metastatic tumours to pituitary are rare. The most frequent are metastases from breast and lung.
Methods. In this paper, three cases of metastatic tumours to the pituitary are presented with panhypopituitarism as a common symptom: I) a 60-year-old gentleman with metastasis of diffuse large B cell lymphoma, who presented with diabetes insipidus, II) a 54-year-old lady with metastatic renal clear cell carcinoma and consequent disturbances in visual acuity, brain nerve paresis and III) a 57-year-old lady with breast cancer metastasis, visual impairment and brain nerve paresis.
Results. A transnasal endoscopic resection of the tumours was performed in all cases, followed by oncological treatment. All patients improved after the treatment.
Conclusions. Despite the rarity of the disease, a metastatic tumour to the pituitary gland must be included in the differential diagnosis when symptoms such as diabetes insipidus, ophthalmoplegy due to brain nerve palsies, rapid course of the disease and headache are observed. In 20% to 30%, pituitary metastases are the first manifestation of a tumour of unknown origin. Surgical and adjuvant therapy may improve the quality of life. The survival and prognosis are generally poor.
Fassett DR, Couldwell WT. Metastases to the pituitary gland. Neurosurg Focus. 2004; 16: 1–4.
He W, Chen F, Dalm B, Kirby PA, Greenlee JD. Metastatic involvement of the pituitary gland: a systematic review with pooled individual patient data analysis. Pituitary. 2015; 18: 159–68.
Komninos J, Vlassopoulou V, Protopapa D, Korfas S, Kontogeorgos G, Sakas DE, et al. Tumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab. 2004; 89: 574–80.
Sioutos P, Yen V, Arbit E. Pituitary gland metastases. Ann Surg Oncol. 1996; 3: 94–9.
Aaberg TM Jr, Kay M, Sternau L. Metastatic tumors to the pituitary. Am J Ophthalmol. 1995; 119: 779–85.
Teears RJ, Silverman EM. Clinicopathologic review of 88 cases of carcinoma metastatic to the pituitary gland. Cancer. 1975; 36: 216–20.
Morita A, Meyer FB, Laws ER. Symptomatic pituitary metastases. J Neurosurg. 1998; 89: 69–73.
Ithimakin S, Suttinont P, Akewanlop C. Pituitary metastasis from renal cell carcinoma: a case report with literature review. J Med Assoc Tahi. 2013; 2: 257–61.
Barbaro D, Desogus N, Boni G. Pituitary metastasis of thyroid cancer. Endocrine. 2013; 43: 485–93.
Bhatoe HS, Badwai S, Dutta V, Kannan N. Pituitary metastasis from medullary carcinoma of thyroid: case report and review of literature. J Neurooncol. 2008; 89: 63–7.
Karamouzis MV, Melachrinou M, Fratzoglou M, Labropoulou-Karatza Ch, Kalofonos HP. Hepatocellular carcinoma metastasis in the pituitary gland: case report and review of the literature. J Neurooncol. 2003; 63: 173–7.
Gormally JF, Izard MA, Robinson BG, Boyle FM. Pituitary metastasis from breast cancer presenting as diabetes insipidus. BMJ Case Rep. 2014; 2014.
Magalhaes JF, Bacchin RP, Costa PS, Alves GM, Filho FF, Stella LC. Breast cancer metastasis to the pituitary gland. Arq Bras Endocrinol Metab. 2014; 58: 869–72.
Spinelli GP, Lo Russo G, Miele E, Prinzi N, Tomao F, Antonelli M, et al. Breast cancer metastatic to the pituitary gland: a case report. World Journal of Surgical Oncology. 2012; 10: 137.
Ismail E, Issam L, Hamid M. Pituitary metastasis of rhabdomyosarcoma: a case report and review of the literature. Journal of Medical Case Reports. 2014; 8: 144.
Ratti M, Passalacqua R, Poli R, Betri E, Crispino M, Poli R, et al. Pituitary gland metastasis from rectal cancer: report of case and literature review. SpringerPlus. 2013; 2: 467.
Mansoor Q, Carey PE, Adams W. A rare ophthalmic presentation of pituitary metastases. BMJ Case Reports. 2012; 2012.
Lim W, Lim DS, Chng CL, Lim AY. Tyroid carcinoma with pituitary metastases: 2 case reports and literature review. Case reports in endocrinology. 2015; 2015: 252157.
Kim YH, Lee BJ, Lee KJ, Cho JH. A case of pituitary metastasis from breast cancer that presented as lef visual disturbance. J Korean Neurosurg Soc. 2012; 51: 94–7.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.