Rare Case with Metastatic Involvement of Hypothalamo-Pituitary and Pineal Body Presenting as Hypopituitarism and Diabetes Insipidus.

Suganuma, Hideki; Takai, Yoshimi; Kita, Tomoko; Okano, Hirokazu; Suzuki, Yoshikazu; Osuga, Yutaka; Chida, Kingo; Sato, Atsuhiko

doi:10.2169/internalmedicine.33.795

Cited by 19 publications

(20 citation statements)

References 9 publications

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“…Metastatic involvement of the pituitary and infundibular stalk is a rare occurrence (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Primary tumor histologic subtypes which have been documented to spread to the pituitary include lung cancer (NSCLC and SCLC), breast cancer, prostate cancer, renal cell carcinoma, and melanoma (among others), with lung cancer and breast cancer being the most frequently reported [4,5,7,13].…”

Section: Discussionmentioning

confidence: 99%

“…Involvement of the pituitary gland by metastatic disease is extremely rare, with most of the existing data based on individual case reports and literature reviews [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. We recently treated a patient with a prior history of colonic adenocarcinoma who presented postoperatively after transsphenoidal resection of an isolated metastatic lesion involving the sellar floor.…”

Section: Introductionmentioning

confidence: 99%

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Intracranial metastatic disease rarely involves the pituitary: retrospective analysis of 935 metastases in 155 patients and review of the literature

et al. 2010

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We present a case report of a patient recently treated at our institution for an isolated non-small cell lung cancer metastatic lesion to the sella, report the lack of involvement of the pituitary gland in a large single-institution series of treated intracranial parenchymal metastases, and review the pertinent literature. We reviewed cranial imaging studies (CT and MRI) for 935 metastases in 155 patients treated at our institution over the previous 3 years for intracranial metastatic disease. Special attention was paid to the skull base to document the presence of any metastatic disease involving the pituitary gland, infundibular stalk, sella turcica (including anterior and posterior clinoids), or diaphragm sellae. We found no other involvement of the pituitary gland or other sellar structures by metastatic disease in this series. Intracranial metastatic disease rarely involves the pituitary gland and infundibular stalk parenchyma, suggesting that this structure may be safely omitted from the treatment field during WBRT and prophylactic cranial irradiation (PCI). This treatment approach should reduce the late sequelae of treatment to this critical organ.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intracranial metastatic disease rarely involves the pituitary: retrospective analysis of 935 metastases in 155 patients and review of the literature

et al. 2010

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“…The first case was described by Forster in 1858; it is cited by Vaquero et al 4 in his recent rewiew. Vaquero et al 4 reviewed 75 cases of pineal region metastases, and approximately half of them were solitary 4,[10][11][12][13][14] . The diagnosis of solitary metastatic lesions in the pineal region prior to the identification of the primary disease is an uncommon situation especially when the primary site is a colorectal adenocarcinoma 4,5 .…”

Section: Case Reportmentioning

confidence: 99%

Pineal metastasis as first clinical manifestation of colorectal adenocarcinoma: case report

Ramina¹,

Neto²,

Mariushi³

et al. 1999

Arq. Neuro-Psiquiatr.

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ABSTRACT-Cerebral metastases from colorectal adenocarcinomas occur in 8% of the cases. Diagnosis is usually made when primary disease and widespread metastases are already known. We report the case of a patient with single metastases in the pineal region as the first clinical manifestation of a colorectal adenocarcinoma. A 48-year-old female with Parinaud's syndrome for 15 days prior her admission was evaluated in our clinic. She had no symptoms or signs of colorectal disease. MRI examination revealed an heterogeneous lesion with peritumoral gadolinium enhancement, located in the pineal region. The tumor was radically resected through an infratentorial/supracerebellar approach. Histology showed metastatic carcinoma and immunohistochemical examination showed gastrointestinal tract adenocarcinoma. Metastases to the pineal region are extremely rare and should be considered in the differential diagnosis of tumors of this region.KEY WORDS: pineal tumors, cerebral metastases, colorectal adenocarcinoma. Metástase pineal como primeira manifestação clinica de adenocarcinoma colorretal: relato de casoRESUMO -Metástases cerebrais derivadas de adenocarcinomas colorretais ocorrem em 8% dos casos. Geralmente a doença primária e as metástases em outros órgãos já são conhecidas quando do momento das manifestações neurológicas. Descrevemos um caso de metástase única na região pineal que promoveu a primeira manifestação clínica de adenocarcinoma colorretal. Uma mulher de 48 anos de idade apresentava há quinze dias de sua admissão ao nosso serviço diplopia e síndrome de Parinaud . O exame de ressonância magnética revelou lesão heterogênea localizada na região pineal. O tumor foi completamente retirado por acesso infratentorial/supracerebelar. O exame histológico revelou tumor metastático indiferenciado e o exame imuno-histoquímico demostrou adenocarcinoma do trato gastrointestinal moderadamente diferenciado. Metástases para a região pineal são extremamente raras e devem ser consideradas no diagnóstico diferencial de tumores nesta região.

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“…Metastases to the pituitary gland as the first manifestation of the disease are uncommon [8,9] and maybe the only site of metastases [10,11]. Sometimes, it is difficult to distinguish between malignant and benign lesions in the pituitary gland.…”

Section: Introductionmentioning

confidence: 99%

Metastatic Breast Carcinoma to the Pituitary Gland that Presented as Diabetes Insipidus: A Case Report

Samaras¹

2017

JCPCR

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Background: Bones, lungs and liver are the most common sites of primary breast tumors. Metastases to the pituitary gland are rare and usually indicate widespread malignant disease. The more frequent manifestations of pituitary gland involvement are diabetes insipidus and visual disturbances.Case Report: This is a 45-year-old woman who was presented with headache, visual disorders, polyuria, polydipsia, significant hypernatremia and dyspnea. The clinical examination revealed a palpable mass in the right breast, while the imaging evaluation showed extensive lung, liver, brain and bone metastases and a metastatic lesion in the pituitary gland, which was compatible with the symptoms of the patient. She received desmopressin for diabetes insipidus control, and underwent whole brain -orbital irradiation and chemotherapy, with resolution of her symptoms and partial remission of the disease. This case shows that diabetes insipidus may be the first manifestation of metastatic breast cancer and early detection and treatment, can improve the associated symptoms.

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Rare Case with Metastatic Involvement of Hypothalamo-Pituitary and Pineal Body Presenting as Hypopituitarism and Diabetes Insipidus.

Cited by 19 publications

References 9 publications

Intracranial metastatic disease rarely involves the pituitary: retrospective analysis of 935 metastases in 155 patients and review of the literature

Intracranial metastatic disease rarely involves the pituitary: retrospective analysis of 935 metastases in 155 patients and review of the literature

Pineal metastasis as first clinical manifestation of colorectal adenocarcinoma: case report

Metastatic Breast Carcinoma to the Pituitary Gland that Presented as Diabetes Insipidus: A Case Report

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