Case Report of a Pituitary Metastasis from Lung Adenocarcinoma Masquerading as Pituitary Adenoma

Rajakumar, R; Rahmatullah, Ijaz Hallaj; Rahim, Anilah Abdul

doi:10.15605/jafes.035.01.24

Cited by 3 publications

(1 citation statement)

References 9 publications

(3 reference statements)

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“…In most lung cancer patients, initial presentation is due to signs and symptoms from the primary lung cancer (dyspnoea, chest pain, persistent cough), or, less frequently, from metastasis to other parts of the body such as lymph nodes or bone. There have been some case reports of previously well patients presenting with visual disturbance as the initial presentation of metastatic LAC, due to pituitary metastasis [ 5 ]. However, in our case report, the patient’s metastasis was to the base of skull and extended into the sella turcica.…”

Section: Discussionmentioning

confidence: 99%

BRAF V600E Mutant Lung Adenocarcinoma Presenting With a Skull Base Metastasis and Pituitary Adenoma Collision Tumour

O’Donovan

Das

Bulusu

2021

Cureus

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We report an unusual initial presentation for metastatic lung adenocarcinoma (LAC) with progressive loss of vision, a rare molecular phenotype and rapid visual response to surgical resection. A 60-year-old female presented with rapid and progressive visual loss over four weeks. Contrast-enhanced CT and MRI scans showed an enhancing lobulated mass in the base of skull infiltrating into the sella turcica. The patient underwent transnasal endoscopic debulking of the mass with rapid improvement in her vision. Histology showed a collision tumour with a pituitary adenoma and a microacinar metastatic adenocarcinoma. Staging CT of the chest, abdomen and pelvis showed a T4 N2 M1 right LAC. Molecular profiling of the metastasis confirmed an activating mutation involving codon 600 of BRAF gene (BRAF V600E). The patient was treated with combination chemotherapy but rapidly deteriorated and unfortunately died due to progressive disease. Efforts to access BRAF/MEK inhibitors for off-label use were unsuccessful. We believe our patient would have benefited from a BRAF/MEK inhibitor. This case illustrates the very unusual presentation of metastatic LAC with visual loss secondary to a collision tumour containing a pituitary adenoma and metastatic adenocarcinoma.

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Section: Discussionmentioning

confidence: 99%

BRAF V600E Mutant Lung Adenocarcinoma Presenting With a Skull Base Metastasis and Pituitary Adenoma Collision Tumour

O’Donovan

Das

Bulusu

2021

Cureus

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Pituitary metastases: a case series and scoping review

Yang,

Begley,

Lynch

et al. 2023

Pituitary

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Pituitary metastasis from lung adenocarcinoma: A case report

Wang,

Liu,

Chen

2024

World J Clin Cases

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BACKGROUND Pituitary gland metastasis is an unusual event, and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis. To date, approximately 15 cases have been reported. CASE SUMMARY Here, we present the case of a 64-year-old woman with pituitary metastasis derived from lung adenocarcinoma, which was difficult to distinguish from other sellar tumors. The patient presented to the neurosurgery clinic with blurred vision and intermittent headache. During hospitalization, brain computed tomography (CT) and magnetic resonance imaging revealed a pituitary macroadenoma. Chest CT revealed irregular nodules in the basal segment of the lower lobe of the left lung, which were likely lung cancer. Positron emission tomography-CT revealed a carbohydrate metabolism tumor in the lungs and sellar region, which was considered malignant. Postoperative pathological examination of the sellar tumor revealed lung adenocarcinoma. CONCLUSION Excision of pituitary metastases combined with radiotherapy and chemotherapy should be a priority treatment for patients with pituitary metastasis.

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Case Report of a Pituitary Metastasis from Lung Adenocarcinoma Masquerading as Pituitary Adenoma

Cited by 3 publications

References 9 publications

BRAF V600E Mutant Lung Adenocarcinoma Presenting With a Skull Base Metastasis and Pituitary Adenoma Collision Tumour

BRAF V600E Mutant Lung Adenocarcinoma Presenting With a Skull Base Metastasis and Pituitary Adenoma Collision Tumour

Pituitary metastases: a case series and scoping review

Pituitary metastasis from lung adenocarcinoma: A case report

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