Pituitary metastases as presenting lesions of malignancy

Metastatic tumors of the pituitary gland and parasellar region are unusual and are generally observed both in an advanced phase of the disease and at autopsy. The occurrence of symptomatic lesions is however quite rare. Though some clinical features may suggest the presence of a metastasis, the diagnosis is unlikely both clinically and radiologically and more common pituitary lesions are generally suspected. The Authors present two very unusual cases in which the pituitary lesions represented the onset symptoms of an otherwise unknown malignancy. Moreover the increased survival of cancer patients and the routine utilization of CT scan and MRI will probably induce, in the next years, a more frequent discovery of pituitary metastases. The Authors suggest that the diagnosis of pituitary metastases should be more closely considered even in the absence of a known primary tumor.