Hypophyseal metastases: A report of three cases and literature review

Neurol Neurochir Pol. 2016 Nov-Dec;50(6):511-516. doi: 10.1016/j.pjnns.2016.08.007. Epub 2016 Sep 4.

Abstract

Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis. A transnasal endoscopic biopsy and resection of the tumour was performed in all patients, followed by the oncological treatment. Despite the rarity of the disease, it is important to suspect a metastatic pituitary tumour especially in the case of diabetes insipidus, ophthalmoplegia, rapid course of the disease and headaches. In 20-30% of patients, a metastasis to the pituitary is the first manifestation of a tumour of unknown origin. Surgical and adjuvant therapy may improve the quality of life. The survival is not affected, however, and the prognosis of the disease is usually poor.

Keywords: Breast cancer; Lymphoma; Metastases; Pituitary tumour; Renal cell carcinoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Gland Neoplasms / pathology*
  • Breast Neoplasms / pathology*
  • Carcinoma / complications
  • Carcinoma / diagnostic imaging
  • Carcinoma / secondary*
  • Carcinoma / therapy
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / therapy
  • Chemoradiotherapy
  • Cranial Nerve Diseases / etiology
  • Cytoreduction Surgical Procedures
  • Diabetes Insipidus / drug therapy
  • Diabetes Insipidus / etiology
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Hypopituitarism / drug therapy
  • Hypopituitarism / etiology
  • Kidney Neoplasms / pathology*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / secondary*
  • Pituitary Neoplasms / therapy
  • Vision Disorders / etiology

Supplementary concepts

  • Combined Pituitary Hormone Deficiency