Pituitary and intradural spinal metastases: an unusual initial presentation of lung cancer

The authors report the clinical and imaging findings for a 47-year-old woman who presented with the classic symptoms of a sellar or suprasellar mass; the lesion was initially diagnosed as germinoma and was treated accordingly. The patient also had intradural, extramedullary spinal metastases. Radiotherapy failed, and the patient died. Autopsy revealed that the lesions were metastatic from previously unrecognized large-cell carcinoma of the lung. This distribution of metastases from a primary lesion not located within the central nervous system is unusual but should be considered in any patient presenting with masses at these sites, particularly if the response to therapy is less than expected.