Metastatic Pituitary Disorders

Novák, Vlastimil; Hrabálek, Lumír; Hampl, Martin; Hoza, Jiří; Fryšák, Zdeněk; Vaverka, Miroslav

doi:10.14735/amko2017273

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…Resection alone, with or without radiotherapy, does not change survival rates (154). The median survival rate after surgical removal of the pituitary tumor is 6 months (155, 156).…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastasis: a rare condition

Javanbakht

D’Apuzzo

Badie

et al. 2018

Endocrine Connections

135

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Tumor metastasis to the pituitary gland is a rare, not well-documented and life-threatening condition associated with a shortened life span. A better understanding of its clinical manifestations could lead to earlier diagnosis, appropriate therapy and potentially improving quality of life. Therefore, we retrospectively studied the charts of patients with pituitary metastases who were treated at the City of Hope National Medical Center (Duarte, CA) from 1984 to 2018. We reviewed and analyzed tumor origin, primary pituitary clinical manifestation, duration between primary tumor diagnosis and pituitary metastasis, type of treatment and patient survival. A total of 11 patients were identified with a mean age of 59.2 years and median survival following the diagnosis of metastasis of 10 months. Breast cancer and lymphoma were the most common primary origins in these cases, and diabetes insipidus and panhypopituitarism were the most common clinical manifestations of their metastasis. We also compared our results with reports in the literature published between 1957 and 2018. A total 289 patients with pituitary metastasis have been reported in the literature. Breast cancer was the most frequent primary origin of the metastasis, and visual symptoms were the most common primary manifestation. The posterior part of the pituitary is more susceptible than the anterior to metastasis. Pituitary metastasis may occur as a consequence of successful primary tumor treatment prolonging the chance of seeding. Future studies are needed to determine the molecular mechanism of metastasis to the pituitary.

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“…Resection alone, with or without radiotherapy, does not change survival rates (154). The median survival rate after surgical removal of the pituitary tumor is 6 months (155, 156).…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastasis: a rare condition

Javanbakht

D’Apuzzo

Badie

et al. 2018

Endocrine Connections

135

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“…PM has a poor prognosis and the management of patients with PM is palliative. The diagnosis of such malignancies is challenging because patients mostly presented nonspecific signs that could overshadow symptoms of hypopituitarism or diabetes insipidus, so the diagnosis is ultimately confirmed by histopathology [ 9 , 12 ]. Sellar masses are rarely constituted by infiltrative neoplasm (such as lymphoma), inflammatory and granulomatous diseases of the pituitary [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature

et al. 2020

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Background Primary nasopharyngeal lymphoma (NPL) is a very rare tumor of Waldeyer ring (WR) lymphoid tissue. It is challenging to differentiate lymphoma infiltration of pituitary from a pituitary adenoma, meningioma infiltration, and other sellar lesions to plan a suitable treatment strategy. We presented for the first time a unique case of NPL with an unusual presentation of oculomotor nerve palsy associated with pan-pituitary involvement in a diabetic patient. Case presentation A 64-year old diabetic woman with no previous history of malignancy presented with intermittent diplopia for about the last nine months. Severe headache, left eye ptosis and hypoglycemic episodes were added to her symptoms after a while. Further complaints include generalized weakness, loss of appetite, generalized musculoskeletal pain, and 6–7 kg weight loss within six months. Her family history was unremarkable. Physical examinations of eyes indicated left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric, and the pupillary reflexes were normal on both eyes. No lymphadenopathy, organomegaly and other abnormalities were found. Magnetic resonance imaging (MRI) showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without bone erosion. Also, both cavernous sinuses were infiltrated and both internal carotid arteries were encased by the neoplastic lesion. It suggested an infiltrative neoplastic lesion which compressed the cranial nerves. Pituitary hormone levels assessment indicated a pan-hypopituitarism. Following nasopharyngeal mucosal biopsy, the immunohistochemistry (IHC) findings revealed a low-grade non-Hodgkin’s B-cell lymphoma. Systemic workup, including cerebrospinal fluid (CSF) studies, bone marrow aspiration, chest and abdominopelvic high-resolution computed tomography (HRCT) indicated no other involvement by the lymphoma. After chemotherapy courses, central adrenal insufficiency, partial central diabetes incipidious (CDI) and central hypothyroidism have been resolved. To our best knowledge, we found 17 cases of NPL with cranial nerve palsy, 1 case of NPL with pan-hypopituitarism and no NPL case with both cranial nerve palsy and pituitary dysfunction. Conclusions The incidence of cranial neuropathy in patients with diabetes should not merely be attributed to diabetic neuropathy without further evaluation.

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“…4 However, the cancer blocks are generally large, with fewer local lymph node metastases and more distant metastasis. [5][6][7] Clinically, chest wall metastases in thyroid adenocarcinoma and follicular thyroid carcinoma are often confused with each other. A case of thyroid adenocarcinoma chest wall metastasis after surgery is presently reported.…”

Section: Introductionmentioning

confidence: 99%

Chest wall metastasis in postoperative thyroid cancer: a case report

Fan¹,

Chen

2019

J Int Med Res

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Thyroid cancer is common in China. Thyroid adenocarcinoma metastases can be local or distal metastasis. Local metastasis presents as a hard and fixed lymph node in the neck, while distant metastases are found in the lung, skull, vertebrae, and pelvis. However, thyroid follicular carcinomas are mostly observed in hematogenous metastases. The thyroid adenocarcinoma and follicular carcinoma of the thyroid gland are often misdiagnosed. Here, we report the case of a 53-year-old female patient. More than 2 years after her initial diagnosis, her left chest wall was physically examined. The results revealed a progressive enlargement that had a hard quality, poor activity, unclear boundary, pressure pain, and percussion pain. Thyroid follicular cell carcinoma was subsequently diagnosed and treated surgically. The thyroid carcinoma had multiple bone metastases, and the thyroid follicular carcinoma had spread to the chest wall through the blood vessels. Thus, preoperative procedures and follow-up should be strengthened because early pathological thyroid follicular carcinoma and thyroid adenoma can easily be misdiagnosed. Pathologic consultation and follow-ups should be strengthened to prevent misdiagnosis.

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Metastatic Pituitary Disorders

Cited by 10 publications

References 19 publications

Pituitary metastasis: a rare condition

Pituitary metastasis: a rare condition

Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature

Chest wall metastasis in postoperative thyroid cancer: a case report

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