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Updated: Oct 2, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Hepatocellular carcinoma with metastasis to the skull base, pituitary gland, sphenoid sinus, and cavernous sinus

T H Aung1, Y C Po, W K Wong

  • 1Department of Neurosurgery, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Kowloon, Hong Kong.

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|February 28, 2002
PubMed

Insights

Hepatocellular carcinoma can metastasize to the skull base, affecting cranial nerves and causing symptoms like double vision. Surgery may be needed for diagnosis and palliative care in these rare cases.

Area of Science:

  • Oncology
  • Neurology
  • Otolaryngology

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver cancer.
  • Metastasis of HCC to the skull base is rare.
  • Skull base metastases can present with neurological deficits.

Observation:

  • Two cases of HCC with metastases to the skull base, pituitary gland, sphenoid sinus, and cavernous sinus are presented.
  • Patients experienced symptoms including diplopia, retro-orbital headache, and multiple cranial nerve palsies.
  • These symptoms indicate significant neurological and orbital involvement.

Findings:

  • Pituitary metastases from HCC can be diagnosed pre-operatively or incidentally via histology.
  • Transsphenoidal resection of pituitary metastases can be both diagnostic and palliative.
  • Histological confirmation is crucial for identifying HCC as the primary source.

Implications:

  • This highlights the importance of considering HCC metastasis in patients with unexplained cranial nerve palsies and skull base lesions.
  • Surgical intervention for pituitary metastases may offer symptomatic relief and diagnostic confirmation.
  • Early recognition and diagnosis of HCC metastasis are vital for patient management.

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