Metastatic prostatic adenocarcinoma presenting as a pituitary mass: Shrinkage of the lesion and clinical improvement with medical treatment

Losa, Marco; Grasso, Marco; Giugni, Enrico; Mortini, Pietro; Acerno, Stefania; Giovanelli, Massimo

doi:10.1002/(sici)1097-0045(19970901)32:4<241::aid-pros3>3.0.co;2-m

Cited by 24 publications

(17 citation statements)

References 11 publications

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“…The frequencies of primary sites are summarized in Fig. 1 (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 10...…”

Section: Resultsmentioning

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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Section: Resultsmentioning

confidence: 99%

Pituitary metastasis: a rare condition

Javanbakht

D’Apuzzo

Badie

et al. 2018

Endocrine Connections

135

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“…17 Because of the rarity of this tumor and its association with end-stage metastatic disease, no significant studies are available in which these various treatment modalities are compared.…”

Section: Treatment For Pituitary Metastasesmentioning

confidence: 99%

“…Gross-total resection is difficult for a number of reasons, including the vascularity of the tumor, resulting in heavy bleeding; local invasiveness into the surrounding bone and cavernous sinus; and infiltration of the hypothalamus and optic nerves. 7,10,17 Reports on two surgical series have indicated no difference in survival attributed to resection. In a review of 36 patients with symptoms, Morita, et al, 22 found no statistically significant difference in survival in the 21 patients who underwent surgery.…”

Section: Treatment For Pituitary Metastasesmentioning

confidence: 99%

Metastases to the pituitary gland

Fassett

Couldwell

2004

FOC

199

182

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Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

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“…The management of SPS metastases is multimodal, including surgical resection, radiation therapy, and chemotherapy [50]. Treatment is mainly palliative and depends on the symptoms and the extent of systemic disease [10, 51].…”

Section: Discussionmentioning

confidence: 99%

Sellar and Parasellar Metastatic Tumors

Altay

Krisht

Couldwell

2012

International Journal of Surgical Oncology

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The sellar and parasellar (SPS) region is a complex area rich in vital neurovascular structures and as such may be the location of first manifestation of a systemic malignancy. Metastases to this region are rare; breast cancer is the most common source among those that metastasize to the SPS region. Ophthalmoplegia, headache, retroorbital or facial pain, diabetes insipidus, and visual field defects are the most commonly reported symptoms. Lack of specific clinical and radiological features renders SPS metastases difficult to differentiate from the other frequently encountered lesions in this area, especially when there is no known history of a primary disease. Currently accepted management is multimodality therapy that includes biopsy and/or palliative surgical resection, radiation, and chemotherapy. Although no significant survival benefits have been shown by the surgical series, surgical resection may improve quality of life. Here we review the relevant literature and present six illustrative cases from our own institution.

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Metastatic prostatic adenocarcinoma presenting as a pituitary mass: Shrinkage of the lesion and clinical improvement with medical treatment

Cited by 24 publications

References 11 publications

Pituitary metastasis: a rare condition

Pituitary metastasis: a rare condition

Metastases to the pituitary gland

Sellar and Parasellar Metastatic Tumors

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