Letters to the Editor Diabetes insipidus as a main symptom of cancer

Cieszyński, Łukasz; Obołończyk, Łukasz; Sworczak, Krzysztof; Berendt-Obołończyk, Monika; Siekierska-Hellmann, Małgorzata

doi:10.5114/aoms.2014.42590

Cited by 3 publications

(7 citation statements)

References 12 publications

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“…Metastatic tumors of the pituitary and sellar region occur in 1% to 3.6% of cancer patients [ 5 , 6 ]. The most common malignancy with PM is lung cancer in men and breast cancer in women [ 4 , 7 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Presentation often includes polyuria, polydipsia, headache, hypopituitarism, visual field defects, and cranial nerves lesions [ 14 ]. The vast majority of patients with PM have diabetes insipidus [ 6 , 8 , 9 , 15 , 16 ]. However, if the anterior pituitary function is impaired, diabetes insipidus may be hidden due to the reduction of glucocorticoid function, becoming evident after starting corticosteroid treatment [ 3 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hypopituitarism in cases of metastasis may also result more frequently from hypothalamic invasion than adeno-pituitary invasion [ 17 ]. Clinically, the symptoms of adenohypophysis dysfunction are usually hidden by the signs of systemic disease due to malignancy [ 5 , 6 ]. Hyperprolactinemia was found in 6.3% of pituitary metastases and is generally attributed to the compression of the stem [ 8 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Changes such as metastatic lesions in another area of the central nervous system, invasion of the cavernous sinus, sclerotic changes around the sella turcica and clivus, isointense signal in both T1 and T2 images, and loss of the hypersignal of the neurohypophysis have been useful in the differentiation of benign, metastatic lesions [ 4 – 6 ]. An intra- and suprasellar tumor dumbbell-shaped indentation at the diaphragm level may also be indicative of PM [ 3 , 6 , 8 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Pituitary Metastasis of Thyroid Carcinoma: A Case Report

et al. 2018

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Patient: Male, 58Final Diagnosis: Pituitary metastais from thyroid carcinomaSymptoms: Visual acuity worseningMedication: —Clinical Procedure: NeurosurgerySpecialty: Endocrinology and MetabolicObjective:Rare diseaseBackground:Pituitary metastasis of thyroid carcinoma is a rare entity. Differential diagnosis with other lesions in the sellar/parasellar region, through clinical, histopathological, immunohistochemical, and imaging is challenging but essential for adequate treatment.Case Report:This case report describes a 58-year-old patient with the previous diagnosis of follicular thyroid carcinoma, with metastasis to cervical lymph nodes, bone, and lung, initially evolving to left palpebral ptosis. In the investigation, laboratory tests showed hypopituitarism, and magnetic resonance imaging of the skull showed a suprasellar formation measuring 2.2×3.5×2.5 cm, which increased in size in a few months. The patient underwent transcranial neurosurgery and subsequent immunohistochemical analysis, which confirmed pituitary metastasis of follicular thyroid carcinoma. The patient underwent chemotherapy and radiotherapy but died 26 months after the onset of symptoms.Conclusions:The differential diagnosis of pituitary metastasis from a benign lesion is difficult. Therefore, a careful analysis of the history and clinical evolution, use of complementary imaging tests, and, where possible, the histopathological and immunohistochemical analysis of the lesion for diagnostic elucidation are necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pituitary Metastasis of Thyroid Carcinoma: A Case Report

et al. 2018

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“…Lung and breast cancers are the most common malignancies to metastasize hematogenously to the pituitary, with a predilection for the posterior pituitary lobe due to direct blood supply from circulation, thus causing CDI. Most cases with pituitary metastasis are asymptomatic except for the 2.5–18% of patiends who present with a DI history [ 10 ]. There have been cases reported in which CDI was the first presenting symptom of underlying malignancy [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Double Trouble – Severe Hypernatremia Secondary to Central Diabetes Insipidus Complicated by Hypercalcemic Nephrogenic Diabetes Insipidus: A Case Report

et al. 2018

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Patient: Female, 40Final Diagnosis: Combined central and nephrogenic diabetes insipidusSymptoms: Confusion • polyuriaMedication: —Clinical Procedure: —Specialty: NephrologyObjective:Rare diseaseBackground:Patients with malignancies often have electrolyte abnormalities. We present a case of a patient with central diabetes insipidus secondary to metastatic pituitary invasion complicated by hypercalcemic nephrogenic diabetes insipidus.Case Report:We present a case of 40-year-old female with a history of stage IV breast cancer with skeletal and leptomeningeal metastasis, who was admitted with polyuria, polydipsia, and recent onset of confusion. The patient was found to have profound hypernatremia and severe hypercalcemia with normal parathyroid and vitamin D serum levels. Urine studies showed low urine osmolality and high urine output, despite the higher serum osmolality. The patient received 5% dextrose for rehydration, 1 dose of intravenous (IV) pamidronate, 1 dose of IV desmopressin, and 4 days of subcutaneous calcitonin 200 international units Q12H. Initially, her urine output in the hospital was in the range of 350–400 milliliters/hour, which responded well to 1 dose of 1-desamino-8d-arginine vasopressin (DDAVP). In the subsequent days, her confusion resolved with normalization of serum sodium and calcium, but she died because of the extensive malignancy.Conclusions:Our case emphasizes the importance of identification of causes and complications of electrolyte abnormalities associated with metastatic cancers. These electrolyte abnormalities can be primary or paraneoplastic and should be actively pursued and treated in such cases.

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Metastatic Lung Cancer Presenting as Monocular Blindness and Panhypopituitarism Secondary to a Pituitary Metastasis

et al. 2020

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Rare co-existance of disease or pathology Background:Sellar masses are most commonly pituitary adenomas, however, about 1% of surgical resected pituitary lesions are found to be metastatic disease. It is hard to distinguish pituitary adenomas from metastatic disease. The most common primary sources for pituitary metastases are breast and lung cancer. Case Report:In this paper, we report the case of a woman who presented with right-sided vision loss who was found to have a sellar mass and panhypopituitarism. Subsequent imaging showed a large mass in her left upper lung with additional lesions in the spleen and adrenal glands. Neurosurgery performed an urgent transsphenoidal resection, with pathology confirming lung adenocarcinoma. Conclusions:This is an unusual presentation of metastatic lung cancer, with the patient's primary symptoms being related to her pituitary metastasis and panhypopituitarism. Pituitary metastases are most commonly asymptomatic, although they can present with visual disturbances, diabetes insipidus, or panhypopituitarism. Pituitary metastases should be on the differential for sellar masses, particularly with specific radiographic findings, visual disturbances, and/or the presence of diabetes insipidus.

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Letters to the Editor Diabetes insipidus as a main symptom of cancer

Cited by 3 publications

References 12 publications

Pituitary Metastasis of Thyroid Carcinoma: A Case Report

Pituitary Metastasis of Thyroid Carcinoma: A Case Report

Double Trouble – Severe Hypernatremia Secondary to Central Diabetes Insipidus Complicated by Hypercalcemic Nephrogenic Diabetes Insipidus: A Case Report

Metastatic Lung Cancer Presenting as Monocular Blindness and Panhypopituitarism Secondary to a Pituitary Metastasis

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