Metastatic carcinoma to the pituitary gland

Four patients with metastatic carcinoma to the pituitary gland are presented. Two of these patients had no previous history of malignancy and, based on clinical, laboratory, and radiological evaluation, a preoperative diagnosis of pituitary adenoma was made. In one patient, the histological diagnosis of two consecutive tumour specimens, obtained 1 year apart, was pituitary adenoma. The correct diagnosis of metastatic renal-cell carcinoma was not ascertained until autopsy. In the second patient, a diffusely infiltrating breast carcinoma was diagnosed by mammography and confirmed by biopsy, after pathological examination of the sellar tumour revealed carcinoma. The third patient underwent mastectomy 3 years earlier for breast carcinoma and had known metastatic disease. The fourth patient had known metastatic endometrial carcinoma when she became symptomatic from a pituitary metastasis. The incidence, clinical features, and pathophysiology of metastatic carcinoma to the pituitary gland are discussed.