Stereotactic Radiosurgery for Pituitary Carcinoma

A pituitary carcinoma (PC) is a rare neoplasm, accounting for only 0.2% of pituitary tumors, and is defined by the presence of noncontiguous metastatic disease. Its management requires a multimodal approach including surgery, irradiation, and medical therapy. Stereotactic radiosurgery (SRS) by means of the Gamma Knife or CyberKnife may be considered potentially useful in such cases. It has mainly been applied for localized metastases and symptomatic lesions, but it may also be effective in control of aggressive tumor growth at the primary site after sufficient surgical debulking of the lesion. Given the infrequency of PC and their heterogeneous nature with regard to the histopathological type, local extension, and location of metastases, large clinical series have not been compiled to date. While, in such cases, SRS is certainly not curative and does not prevent disease progression, it is quite reasonable to incorporate this treatment option into a multimodal management strategy and apply it judiciously at the treating clinician's discretion on a case-by-case basis.