Pituitary Metastasis of Thyroid Carcinoma: A Case Report

Mota, Juliana Souza; Caldas, Adriana de Sá; Nascimento, Ana Giselia; Faria, Manuel dos Santos; Sobral, Carla Souza Pereira

doi:10.12659/ajcr.909523

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Rarely does a DTC metastasise to the pituitary. There are fewer than 20 published cases of a pituitary metastasis arising from an FTC and only one report of a pituitary metastasis from HCC was found in our literature search 3 4. We describe another case of a pituitary metastasis from HCC.…”

Section: Introductionmentioning

confidence: 82%

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Pituitary metastases of Hürthle cell carcinoma of the thyroid

et al. 2021

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An 85-year-old man was referred to endocrinology following the discovery of an incidental pituitary mass on cranial imaging which was thought to be a non-functioning adenoma during an admission with headaches, lethargy, confusion and hyponatraemia. He had a history of Hürthle cell carcinoma of the thyroid treated with total thyroidectomy, ablative radioiodine therapy and thyroxine replacement. Subsequently, he developed metastatic spread to the neck, lungs and skeleton. About 9 months later, the patient had deterioration of vision. MRI showed a rapidly expanding pituitary mass with compression of the optic chiasm. Biochemical investigations confirmed hypocortisolism and hypogonadism. The patient underwent trans-sphenoidal resection of the pituitary mass followed by external beam radiotherapy to the pituitary bed. Histopathology confirmed a metastatic deposit of Hürthle cell carcinoma, which is a rare and aggressive variant of follicular thyroid carcinoma.

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Section: Introductionmentioning

confidence: 82%

“…HCCs are a group of heterogeneous malignant tumours that exhibit diverse biological features and represent less than 5% of DTC 3. HCC is regarded as an oncocytic variant of FTC by the WHO 5.…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastases of Hürthle cell carcinoma of the thyroid

et al. 2021

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“…We performed research in PubMed, looking for other cases of pituitary metastases and we found 107 cases between case series and single case reports ( 11 – 30 -33). We found only 7 cases of pituitary metastasis originating from gastroenteric tract ( 12 , 25 , 29 , 31 , 32 ) and no cases of pituitary metastasis from gastro-esophageal junction adenocarcinoma ( Supplementary Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma

et al. 2023

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IntroductionPituitary metastases are very rare in cancer patients and often originate from lung or breast tumors. They usually occur in patients with known metastatic disease, but rarely may be the first presentation of the primary tumor.MethodsWe present the case of a 58 years-old-man who reported a three-month history of polyuria-polydipsia syndrome, generalized asthenia, panhypopituitarism and bitemporal hemianopsia. Brain-MRI showed a voluminous pituitary mass causing posterior sellar enlargement and compression of the surrounding structures including pituitary stalk, optic chiasm, and optic nerves.ResultsThe patient underwent neurosurgical removal of the mass. Histological examination revealed a poorly differentiated adenocarcinoma of uncertain origin. A total body CT scan showed a mass in the left kidney that was subsequently removed. Histological features were consistent with a clear cell carcinoma. However, endoscopic examination of the digestive tract revealed an ulcerating and infiltrating adenocarcinoma of the gastric cardia. Total body PET/CT scan with 18F-FDG confirmed an isolated area of accumulation in the gastric cardia, with no hyperaccumulation at other sites.ConclusionTo the best of our knowledge, there are no reports of pituitary metastases from gastric cardia adenocarcinoma. Our patient presented with symptoms of sellar involvement and without evidence of other body metastases. Therefore, sudden onset of diabetes insipidus and visual deterioration should lead to the suspicion of a rapidly growing pituitary mass, which may be the presenting manifestation of a primary extracranial adenocarcinoma. Histological investigation of the pituitary mass can guide the diagnostic workup, which must however be complete.

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“…Immunochemistry was suggestive of ATC with thyroid transcription factor 1 (TTF-1), cytokeratin, Pax8, and C53 positive while calcitonin and thyroglobulin were negative. Immunohistochemistry can complement histopathology for accurate diagnosis of uncommon tumors [12]. Radiation therapy is a well-tolerated treatment approach with or without surgery or chemotherapy in the context of loco-regional control for patients with ATC [13].…”

Section: Discussionmentioning

confidence: 99%

Metastasis to Stomach in a Patient with Anaplastic Thyroid Carcinoma: A Clinical Challenge

2019

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Patient: Female, 71Final Diagnosis: Anaplastic thyroid carcinomaSymptoms: BreathlessnessMedication: —Clinical Procedure: Total thyroidectomy along with left modified radical neck dissectionSpecialty: OncologyObjective:Unusual clinical courseBackground:Anaplastic thyroid carcinoma (ATC) is an uncommon and aggressive form of human cancer. Despite advancement in multimodal therapy for patients with ATC, the prognosis remains poor. Most patients presenting with ATC have metastasis to the lungs and regional lymph nodes. Gastrointestinal tract metastasis is a rare entity observed among patients with ATC. We report a case of ATC with gastrointestinal metastasis.Case Report:A 72-year-old euthyroid female with hypertension presented to the clinic with swelling of the neck and breathlessness. Fine needle aspiration cytology revealed colloid goiter. Positron emission tomography and computed tomography revealed hypermetabolic, lobulated mass in left hemi-thyroid, displacing trachea, and hypermetabolic lymph nodes on the left side. The patient underwent total thyroidectomy along with left modified radical neck dissection. Histopathology and immunochemistry were suggestive of ATC with thyroid transcription factor 1 (TTF-1), cytokeratin, Pax8, and C53 positive while calcitonin and thyroglobulin were negative. The patient presented with persistent nausea and vomiting during adjuvant radiation therapy. After radiation therapy, the patient underwent upper gastrointestinal endoscopy that revealed large polypoidal lesions in the stomach. No active bleeding was observed. Biopsy results confirmed it to be metastasis from ATC.Conclusions:ATC can spread to distant sites including the gastrointestinal tract. Patients with ATC metastasis have a poor prognosis despite multimodal therapy. This is the first case of ATC with gastrointestinal metastasis reported in India.

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Pituitary Metastasis of Thyroid Carcinoma: A Case Report

Cited by 11 publications

References 25 publications

Pituitary metastases of Hürthle cell carcinoma of the thyroid

Pituitary metastases of Hürthle cell carcinoma of the thyroid

Case Report: Pituitary metastasis as a presenting manifestation of silent gastric cardia adenocarcinoma

Metastasis to Stomach in a Patient with Anaplastic Thyroid Carcinoma: A Clinical Challenge

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