Metastatic Tumors of the Sella Turcica Masquerading as Primary Pituitary Tumors*

Abstract

Tumors metastatic to the pituitary gland are uncommon, but may mimic a typical pituitary adenoma and are an important part of the differential diagnosis of sellar mass lesions. Pituitary metastases were treated by transsphenoidal microsurgical removal in 14 patients. Most tumors appeared in men in the sixth and seventh decades of life. Half of the patients presented with visual loss, 6 had anterior hypopituitarism, and 4 had diabetes insipidus. Primary cancer had been diagnosed and treated previously in 5 patients. In the remaining 9 patients, the transsphenoidal operation provided the initial diagnosis of cancer, and primary lesions subsequently were detected in all but 2. Transsphenoidal surgery also provided satisfactory decompression of the mass effect related to the tumors, improving the presenting symptoms in the majority of patients, and the surgery was free of mortality or serious complications.

Hypopituitarism due to Pituitary Metastasis of Lung Cancer: Case of a 21-Year-Old Man.

“…ache, extraocular nerve palsy and diabetes insipidus are highly suggestive of a metastasis to the sella regardless of whether the patient has been proven to have cancer (17). The present patient had reported headache and double vision subjectively but there were no objective findings suggesting extraocular nerve palsy.…”

“…Another possible interpretation of the initial hyperprolactinemia is that hypothalamus-derived prolactin inhibiting factor, which is considered to be dopamine, is blocked by the infundibular invasion of the pituitary metastasis. Such a condition is thought to be rare (6,17,19). Twentyfour-hour urinary 17-OHCS was within the normal range, which is inconsistent with the reduced plasma and urinary cortisol levels.…”

Pituitary Gland Metastasis of Breast Cancer: A Case Report

“…[2][3][4][5] The most common symptom of pituitary metastasis seems to be diabetes insipidus. 1,[6][7][8][9][10] Visual impairment resulting from optic chiasm compression seems to be second most common presentation. 1,[12][13][14][15] Complete or partial pituitary insufficiency is the third most common presentation of pituitary metastases.…”

“…1,[12][13][14][15] Complete or partial pituitary insufficiency is the third most common presentation of pituitary metastases. 1,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] It is usually associated with a mass effect of a large tumour.…”

Diabetes insipidus due to pituitary metastasis in a woman with lung adenocarcinoma: a case report

“…The incidences of these differentiating symptoms correspond to the prevalence of the different metastatic locations (anterior vs. posterior pituitary). Branch and Laws [10] proposed that if a patient presents with the clinical triad of headache, extraocular nerve palsy, and diabetes insipidus, metastasis to the sella should be strongly suspected. Our case presented with one element of the clinical triad, diabetes insipidus, and partial anterior pituitary insufficiency of gonadotrophs (low levels of follicle-stimulating hormone and luteinizing hormone).…”