Pituitary metastases: a real-world single-center surgical cohort

The pituitary is a rare site for metastatic spread. Pituitary metastases (PMs) account for about 1% of lesions removed by pituitary surgery. Data on epidemiology, symptoms, pituitary hormone assessment, and radiological findings are limited. This paper aimed to describe our retrospective cohort of histologically diagnosed PMs.

A single-center, retrospective, observational cohort study was conducted on patients diagnosed with PM who underwent surgical resection between 2000 to 2025. We analyzed epidemiological, clinical, radiological, and surgical data about these lesions.

Nineteen PMs were identified (9 males and 10 females). The mean age at diagnosis of PMs was 57.8 years. Most patients presented with symptoms at the first clinical evaluation, and the most frequent onset symptom was neuro-ophthalmological disorders (84.2%). Pituitary hormonal deficiencies were diagnosed in 12 patients: three patients were affected by pan-hypopituitarism (16.7%), one patient (5.5%) by anterior partial hypopituitarism, 6 patients with only an ACTH deficiency. AVD was diagnosed in 7 patients (36.8%). In 21% of patients, the pituitary gland was identified as the first site of metastasis of the primary neoplasm. Fourteen patients out of the 16 with available data (87.5%) carried residual/recurrent disease after surgery. The most frequently found neoplasms were lung cancer and breast cancer. Five patients underwent radiotherapy after surgery. Median overall survival from surgery was 23.5 months.

PMs had an increasing incidence in recent years and should be considered in the etiological diagnosis of pituitary hormonal deficiencies and/or signs due to the impairment of anatomical structures of the sella turcica.