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Background: Breast cancer commonly metastasizes to the lung, vertebrae or liver but rarely to the pituitary gland. The majority of cases have been reported during autopsy; however, with the improvements in diagnostic methods, there has been an increasing number of cases reported in the clinical setting. The main symptoms of pituitary metastasis are reported to be headache, diabetes insipidus and visual field defects, which may cause confusion regarding the clinical diagnosis.Case presentation: The present study describes a case of pituitary metastasis symptoms of diabetes insipidus and loss of vision in a patient with breast cancer. After the patient completed the evaluation, a neuroendoscopy-assisted endonasal transsphenoidal tumor resection was performed. The postoperative biopsy revealed metastatic breast cancer.Conclusions: The present study analyzed this patient and 16 other cases of pituitary metastases collected from the PubMed database. Lung cancer, breast cancer and lymphoma could metastasize to the sellar region, while certain other tumors from the liver, parotid, colon, prostate, stomach, kidney, thyroid or skin were also observed. The clinical manifestation was often dominated by pituitary dysfunction, intracranial hypertension and visual field defects. Certain patients may suffer from oculomotor nerve paralysis, electrolyte imbalance, diabetes insipidus or a loss of vision. Imaging findings revealed that sellar metastases often invaded the suprasellar region. In a few cases, the lesion enclosed intracranial vessels, and invaded the cavernous sinus or Meckel's cave. These characteristics resulted in difficulties during surgery.