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Related Experiment Video

Updated: Dec 24, 2025

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

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Metastatic Pituitary Carcinoma Causing Cord Compression.

Wai Cheong Soon1, Marcin Czyz1, Jasmeet Dhir1

  • 1Department of Neurosurgery, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom.

World Neurosurgery
|April 15, 2020
PubMed
Summary

Pituitary drop metastasis, a rare complication of Cushing disease, can cause spinal cord compression. Early suspicion and diagnosis are crucial for effective treatment and patient outcomes.

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Answer to the letter to the editor of s. biswas, et al. concerning "machine learning in predicting cauda equina imaging outcomes - a solution to the problem" by r. sun et al. (eur spine J [2025]: doi.org/10.1007/s00586-024-08591-1).

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Machine learning in predicting cauda equina imaging outcomes- a solution to the problem.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·2024

Area of Science:

  • Neuro-oncology
  • Endocrinology
  • Spinal Surgery

Background:

  • The patient had a history of recurrent pituitary tumor, Cushing disease, and Nelson syndrome, with prior bilateral adrenalectomy and hypophysectomy.
  • He underwent multiple treatments including surgery, radiosurgery, and chemotherapy for recurrent pituitary tumor.

Observation:

  • A rising adrenocorticotrophin (ACTH) level was noted during follow-up.
  • Magnetic resonance imaging revealed a large intradural extramedullary lesion at the C2-3 level causing spinal cord compression.

Findings:

  • Surgical debulking of the lesion was performed with continuous monitoring of neurophysiological potentials.
  • Histologic analysis confirmed a pituitary tumor with synaptophysin and ACTH expression, consistent with pituitary drop metastasis.
Keywords:
Carcinoma metastasisCord compressionPituitary tumorSpine

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Last Updated: Dec 24, 2025

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Implications:

  • Pituitary drop metastasis is a rare but critical diagnosis in patients with a history of pituitary tumors.
  • Radiologic findings can mimic other spinal tumors, necessitating a high index of suspicion.
  • Prompt surgical intervention can lead to favorable neurological outcomes.