Pituitary metastases: a case series and scoping review

Yang, Kaiyun; Begley, Sabrina L.; Lynch, Daniel; Ye, Vincent; Saini, Jasleen; Gutierrez, Enrique; Vialet, Jaclyn; Millar, Barbara-Ann; Conrad, Tatianna; Laperriere, Normand; Bernstein, Mark; Zadeh, Gelareh; Shultz, David B.; Kongkham, Paul N.

doi:10.1007/s11102-023-01349-w

Cited by 5 publications

(15 citation statements)

References 74 publications

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“…Additionally, they may present symptoms similar to those of primary pituitary lesions, including visual dysfunction and endocrine abnormalities in 65% of patients, half of whom experience panhypopituitarism. 7 Most patients exhibit pituitary dysfunction before systemic lymphoma becomes evident, however, in other cases, lymphoma can precede pituitary dysfunction or develop during the course of the disease, as was the case with our patient, whose pituitary symptoms were documented during hospitalization. 3 , 5 , 6 …”

Section: Discussionsupporting

confidence: 60%

“…PM typically occur in patients with an average age of around 60 years, with no significant differences between men and women. 7 Pituitary infiltration by systemic lymphoma is an exceedingly rare phenomenon, accounting for only 0.5% of cases. 3 This is in contrast to cases secondary to solid tumors, which account for 60% of PM.…”

Section: Discussionmentioning

confidence: 99%

“… 4 The most frequent primary tumor sites for these cases include the lung (28%), breast (19%), kidney (15%), thyroid (8%), gastrointestinal tract (6%) and prostate (6%). 7 …”

Section: Discussionmentioning

confidence: 99%

“…The average time elapsed between the diagnosis of the primary cancer and the detection of PM is 6.5 months, although in nearly half of the cases, they are diagnosed simultaneously. 7 …”

Section: Discussionmentioning

confidence: 99%

“…There may be underdiagnosis of anterior pituitary dysfunction, as its symptoms could be incorrectly attributed to systemic lymphoma. 7 …”

Section: Discussionmentioning

confidence: 99%

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Panhypopituitarism in a Patient with Burkitt Lymphoma: A Diagnostic and Therapeutic Challenge

Dextre-Espinoza,

Ildefonso-Najarro,

Concepción-Zavaleta

et al. 2023

touchREVIEWS in Endocrinology

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Pituitary infiltration by systemic lymphoma is an exceedingly rare occurrence. Given its high mortality rate, it is crucial to recognize its clinical, biochemical and radiological features in order to provide timely intervention. We present the case of a 26-year-old male with a history of human immunodeficiency virus (HIV) infection who presented to the hospital with severe anemia, persistent fever, weight loss and diarrhea over the previous 4 months. Physical examination revealed a compromised general condition, fever, pallor, hepatomegaly and lymphadenopathy. Cervical lymph node biopsy confirmed Burkitt lymphoma (BL). During hospitalization, the patient developed polyuria, polydipsia, hypernatremia, fluid-resistant hypotension and hypoglycaemia. Corticosteroid therapy was initiated due to suspected adrenal insufficiency, resulting in clinical improvement but exacerbation of polyuria and hypernatremia. Plasma and urinary osmolarity confirmed arginine vasopressin deficiency, and assessment of anterior pituitary reserve revealed hypopituitarism, necessitating hormonal replacement therapy. Sellar magnetic resonance imaging with contrast revealed pituitary infiltration. The patient subsequently developed septic shock and died. BL accounts for approximately 10% of the cases of pituitary infiltration associated with lymphoma. Clinical presentation is heterogeneous, with panhypopituitarism often serving as the initial manifestation. Sellar magnetic resonance imaging plays a pivotal role in the differential diagnosis. Management typically entails chemotherapy, immunotherapy, radiation and hormonal replacement therapy. This case report describes a patient with BL and HIV infection who developed panhypopituitarism due to pituitary infiltration, an exceedingly rare presentation considered a medical emergency.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

“… 4 The most frequent primary tumor sites for these cases include the lung (28%), breast (19%), kidney (15%), thyroid (8%), gastrointestinal tract (6%) and prostate (6%). 7 …”

Section: Discussionmentioning

confidence: 99%

“…The average time elapsed between the diagnosis of the primary cancer and the detection of PM is 6.5 months, although in nearly half of the cases, they are diagnosed simultaneously. 7 …”

Section: Discussionmentioning

confidence: 99%

“…There may be underdiagnosis of anterior pituitary dysfunction, as its symptoms could be incorrectly attributed to systemic lymphoma. 7 …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Panhypopituitarism in a Patient with Burkitt Lymphoma: A Diagnostic and Therapeutic Challenge

Dextre-Espinoza,

Ildefonso-Najarro,

Concepción-Zavaleta

et al. 2023

touchREVIEWS in Endocrinology

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Metastases to the pituitary gland: insights from the German pituitary tumor registry

Haberbosch,

Schmid,

Hubertus

et al. 2023

Pituitary

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Metastatic involvement of the pituitary gland is a rare but clinically significant phenomenon, that often poses diagnostic and therapeutic challenges. The aim of this study was to provide a comprehensive analysis of the origin of pituitary metastases using data from the German Pituitary Tumor Registry, one of the globally largest collections of pituitary pathology specimens. Here, we report data from a retrospective analysis of patients with metastases to the pituitary registered between 1990 and 2022. Out of 17,896 pituitary cases in the registry during this period, a total of 96 metastases to the pituitary gland were identified, accounting for 0.5% of all pituitary tumors in the registry. The mean age of the patients was 64 years. Breast cancer was identified as the primary tumor in 25% of total cases (n = 24/96) and in 50% of female patients. The second most prevalent primary tumor was lung cancer (18.75%, n = 18/96), followed by renal cell carcinoma (14.58%, n = 14/96). In comparison to current meta-analyses, this cohort shows a higher prevalence of metastases originating from the kidney. Furthermore, in contrast to the existing literature, no case of primary thyroid tumor was identified. Our study highlights the importance of pituitary metastases as a differential diagnosis in patients presenting with pituitary tumors.

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Morbidities and mortality among hospitalized patients with hypopituitarism: Prevalence, causes and management

Ebrahimi,

Andereggen,

Christ

2024

Rev Endocr Metab Disord

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Hypopituitarism is a highly heterogeneous multisystem disorder that can have a major impact on long-term morbidity and mortality, but even more so during acute medical conditions requiring hospitalization. Recent studies suggest a significant in-hospital burden with prolonged length of stay, increased rate of intensive care unit (ICU) admission, and initiation of mechanical ventilation − all of which may lead to an increased risk of in-hospital mortality. On the one hand, patients with hypopituitarism are often burdened by metabolic complications, including obesity, hypertension, dyslipidemia, and hyperglycemia, which alone, or in combination, are known to significantly alter relevant physiological mechanisms, including metabolism, innate and adaptive immune responses, coagulation, and wound healing, thereby contributing to adverse in-hospital outcomes. On the other hand, depending on the extent and the number of pituitary hormone deficiencies, early recognition of hormone deficiencies and appropriate management and replacement strategy within a well-organized multidisciplinary team are even stronger determinants of short-term outcomes during acute hospitalization in this vulnerable patient population. This review aims to provide an up-to-date summary of recent advances in pathophysiologic understanding, clinical implications, and recommendations for optimized multidisciplinary management of hospitalized patients with hypopituitarism.

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Pituitary metastases: a case series and scoping review

Cited by 5 publications

References 74 publications

Panhypopituitarism in a Patient with Burkitt Lymphoma: A Diagnostic and Therapeutic Challenge

Panhypopituitarism in a Patient with Burkitt Lymphoma: A Diagnostic and Therapeutic Challenge

Metastases to the pituitary gland: insights from the German pituitary tumor registry

Morbidities and mortality among hospitalized patients with hypopituitarism: Prevalence, causes and management

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