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Pituitary gland metastases

P Sioutos1, V Yen, E Arbit

  • 1Neurosurgery Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

Annals of Surgical Oncology
|January 1, 1996
PubMed
Summary

Pituitary metastasis, though rare, presents diagnostic challenges. Early recognition of diabetes insipidus and pituitary masses in cancer patients aids diagnosis and palliative treatment.

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Area of Science:

  • Neuroendocrinology
  • Oncology
  • Radiology

Background:

  • Symptomatic pituitary metastasis is rare and can mimic pituitary adenomas clinically and radiographically.
  • Distinguishing metastasis from primary pituitary tumors presents a diagnostic challenge.

Observation:

  • Eight cases of pituitary metastasis were reviewed for clinical features, radiographic findings, treatment, and outcomes.
  • Diabetes insipidus was a common symptom, and the initial manifestation of malignancy in two patients.
  • Headaches, panhypopituitarism, and visual field defects were also observed.

Findings:

  • Fifty percent of patients had metastasis limited to the pituitary gland.
  • All patients received radiotherapy and vasopressin; two underwent tumor resection.
  • Prognosis was poor, with most patients dying within months of diagnosis.

Implications:

  • Diabetes insipidus with a pituitary mass in cancer patients strongly suggests metastasis.
  • Palliative care, including vasopressin and radiotherapy, is a reasonable treatment approach.

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