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Pituitary metastases: MR findings
N A Mayr1, W T Yuh, M G Muhonen
1Department of Radiology, University of Iowa College of Medicine, Iowa City.
Journal of Computer Assisted Tomography
|May 1, 1993
Summary
Pituitary metastases are rare and hard to distinguish from adenomas. MRI findings like small, isointense lesions and cavernous sinus involvement can aid diagnosis, with anterior and posterior lobe symptoms being equally common.
Area of Science:
- Radiology
- Neurology
- Endocrinology
Background:
- Pituitary gland metastases are infrequent and challenging to differentiate from pituitary adenomas on imaging.
- Distinguishing metastatic lesions from primary pituitary tumors is crucial for appropriate patient management.
Purpose of the Study:
- To identify characteristic magnetic resonance (MR) imaging findings and clinical presentations of pituitary metastases.
- To compare the frequency of anterior versus posterior pituitary lobe symptoms in patients with pituitary metastases.
Main Methods:
- Retrospective review of MR examinations and clinical records of nine patients with confirmed pituitary metastases.
- Analysis of clinical symptoms, including cranial nerve deficits and pituitary dysfunction.
- Evaluation of MR imaging features such as lesion size, signal intensity, and involvement of adjacent structures.
Main Results:
- The most common symptoms were acute cranial nerve deficits (67%) and pituitary dysfunction (30%), progressing rapidly over 1-4 weeks.
- Multiple cranial nerve involvement (83%) was frequent, often due to adjacent cavernous sinus invasion.
- MR findings included small enhancing lesions (< or = 1.5 cm in 56%), isointense to brain on T1- and T2-weighted images (78%), and involvement of the hypothalamus/pituitary infundibulum (44%) or cavernous sinus (56%).
- Anterior and posterior pituitary lobe symptoms occurred with similar frequency, contrasting with previous reports.
Conclusions:
- Pituitary metastases present with acute neurological and endocrine dysfunction.
- Specific MR imaging features, including lesion characteristics and adjacent structure involvement, can help differentiate metastases from adenomas.
- The study highlights the equal prevalence of anterior and posterior pituitary lobe symptoms in pituitary metastases.