A pituitary metastasis, an adenoma and potential hypophysitis: A case report of tumour to tumour metastasis in the pituitary

Castle-Kirszbaum, Mendel; Phung, Teik Beng; Luen, Stephen J.; Rimmer, Joanne; Chandra, Ronil V.; Goldschlager, Tony

doi:10.1016/j.jocn.2020.09.033

Cited by 12 publications

(4 citation statements)

References 38 publications

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“…Composite tumors of the pituitary consisting of metastasis within an adenoma are extremely rare, with only 37 cases reported so far to our knowledge [6,7]. Of the 37 reported cases of metastasis within adenomas, 20 were found in non-functioning adenomas, seven in prolactinomas [8][9][10][11][12][13][14] (Table 2), four in adenomas that are GH-secreting, three secreting adrenocorticotropic hormone (ACTH), and three cases did not report the specific pathology of the adenoma [6].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Seeding From a Gastrointestinal Neoplasia in a Pituitary Adenoma: A Case Report and Literature Review

Gariepy¹,

Champagne²

2023

Cureus

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Pituitary composite tumors consisting of metastasis within an adenoma are rare and aggressive entities. We present a case of esophageal adenocarcinoma metastasis at a prolactinoma presenting in a unique fashion and highlight how this case could contribute to a better understanding and early recognition of this condition. The patient was a 65-year-old male who presented with partial palsy of the third and sixth cranial nerves. He had a history of treated esophageal adenocarcinoma. He also had a known small parasellar lesion, with an elevated prolactin. Investigations showed a rapid progression of the parasellar lesion and normalization of prolactin. Partial surgical resection was performed, and pathology confirmed metastasis of the known digestive tract neoplasia. Although extremely rare, dual pathology of pituitary metastasis within adenomas should be considered in the differential diagnosis of sellar masses. Atypical behavior of benign adenomas, including rapid growth, spontaneous normalization of prolactin, or progression despite medical treatment should prompt medical teams to reconsider their diagnosis.

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Section: Discussionmentioning

confidence: 99%

Metastatic Seeding From a Gastrointestinal Neoplasia in a Pituitary Adenoma: A Case Report and Literature Review

Gariepy¹,

Champagne²

2023

Cureus

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“…In the setting of central diabetes insipidus (DI), glucocorticoid deficiency reduces free water clearance, evidence for a direct effect on renal water handling independent of AVP [30][31][32][33]. Impaired aquaresis in glucocorticoid deficiency is thought to relate to a reduction in renal blood flow, glomerular filtration, and direct effects on the water permeability of the distal tubules [30,34].…”

Section: Glucocorticoids and Water Balancementioning

confidence: 99%

Glucocorticoids and Water Balance: Implications for Hyponatremia Management and Pituitary Surgery

Castle-Kirszbaum¹,

Goldschlager²,

Shi³

et al. 2023

Neuroendocrinology

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Water balance is fundamental to all homeostasis. The hypothalamic pituitary adrenal (HPA) axis influences water balance through the effects of corticotropin releasing hormone (CRH) and cortisol on arginine vasopressin (AVP) secretion, and the peripheral effects of cortisol on hemodynamic and renal water handling. In this review, we explore the complex interplay of glucocorticoids with water balance, with particular attention to hyponatremia and pituitary surgery.

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“…Metastasis to bone and lung were the most common, occurring in 13 and 10 patients, respectively. Other sites included lymph nodes (6), liver (4), adrenal gland (3), thyroid (2), thoracic wall (1), and opposite breast (1). ere were only three cases that reported central metastasis in addition to PM.…”

Section: Additional Sites Of Metastasismentioning

confidence: 99%

Early and isolated breast cancer metastasis to the pituitary: A case report and systematic review

Rasiah

Albakr

Kosteniuk

et al. 2022

Surgical Neurology International

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Background: Pituitary metastases (PMs) arising from breast cancer tend to occur many years following initial diagnosis, and after other systemic metastasis have been identified. Survival is generally considered to be poor. However, there are cases where patients present with an isolated metastatic lesion in the pituitary. Survival in this subset of patients has not been evaluated. We present a case of isolated PM that presented two years after initial diagnosis of breast cancer. We performed a systematic review of 38 breast cancer patients with PM. We report presentation, treatment strategy, and outcomes of breast cancer metastasis to the pituitary and highlight cases of isolated PM. Case Description: A 39 year old female presented with complaints of headache and polydipsia two years after diagnosis with breast cancer. Systemic workup was unremarkable, but brain imaging identified an isolated PM. Transsphenoidal debulking was performed with adjuvant radiation therapy (RT) targeted to the sellar region. Unfortunately, she passed away 9 months later from systemic progression. Conclusion: A total of 38 patients were included systematic review. Of these, 13 had isolated PM. Prevalent signs/ symptoms included visual disturbance, diabetes insipidus (DI), and hypothalamic dysfunction. Patients treated with surgical resection and adjuvant chemotherapy (ChT), or RT had better survival than those treated with resection alone. Patients that receive treatment for isolated PM may survive for many years without progression or recurrence.

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A pituitary metastasis, an adenoma and potential hypophysitis: A case report of tumour to tumour metastasis in the pituitary

Cited by 12 publications

References 38 publications

Metastatic Seeding From a Gastrointestinal Neoplasia in a Pituitary Adenoma: A Case Report and Literature Review

Metastatic Seeding From a Gastrointestinal Neoplasia in a Pituitary Adenoma: A Case Report and Literature Review

Glucocorticoids and Water Balance: Implications for Hyponatremia Management and Pituitary Surgery

Early and isolated breast cancer metastasis to the pituitary: A case report and systematic review

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