Hypophyseal metastases: A report of three cases and literature review

Ravnik, Janez; Ŝmigoc, Tomaž; Bunc, Gorazd; Lanišnik, Boštjan; Ksela, Ursa; Ravnik, Maja; Velnar, Tomaž

doi:10.1016/j.pjnns.2016.08.007

Cited by 20 publications

(13 citation statements)

References 23 publications

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“…The increase in the lifespan of cancer patients has resulted in an increased prevalence of metastases to otherwise rare sites. Pituitary metastases have been described in a range 3-27% in autopsy series in the context of disseminated malignancy [98], occurring mostly in patients with breast (37.2%) and lung (24.2%) cancer [18,99,100]. Panhypopituitarism (27.7%) and DI (27.7-70%) were between the most common clinical presentation following visual abnormalities [18,100].…”

Section: Pituitary Metastasesmentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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Hypopituitarism includes all clinical conditions that result in partial or complete failure of the anterior and posterior lobe of the pituitary gland’s ability to secrete hormones. The aim of management is usually to replace the target-hormone of hypothalamo-pituitary-endocrine gland axis with the exceptions of secondary hypogonadism when fertility is required, and growth hormone deficiency (GHD), and to safely minimise both symptoms and clinical signs. Adrenocorticotropic hormone deficiency replacement is best performed with the immediate-release oral glucocorticoid hydrocortisone (HC) in 2–3 divided doses. However, novel once-daily modified-release HC targets a more physiological exposure of glucocorticoids. GHD is treated currently with daily subcutaneous GH, but current research is focusing on the development of once-weekly administration of recombinant GH. Hypogonadism is targeted with testosterone replacement in men and on estrogen replacement therapy in women; when fertility is wanted, replacement targets secondary or tertiary levels of hormonal settings. Thyroid-stimulating hormone replacement therapy follows the rules of primary thyroid gland failure with L-thyroxine replacement. Central diabetes insipidus is nowadays replaced by desmopressin. Certain clinical scenarios may have to be promptly managed to avoid short-term or long-term sequelae such as pregnancy in patients with hypopituitarism, pituitary apoplexy, adrenal crisis, and pituitary metastases.

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Section: Pituitary Metastasesmentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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“…Pituitary involvement was the initial presentation of a systemic lymphoma in 58% of patients (n = 18) [ 4 , 8 , 13 , 16 , 18 , 20-23 , 25 , 27-31 , 33 ]. Also, a similar proportion of cases was identified throughout the disease activity (22%, n = 7) [ 9-11 , 14 , 15 , 19 , 24 ] or were a consequence of lymphoma recurrence (19%, n = 6) [ 6 , 7 , 12 , 17 , 26 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in our case series and after literature review, we noticed that lymphoma may infiltrate more commonly the anterior (52%, n = 16) [ 7 , 9 , 12 , 13 , 16-20 , 22 , 23 , 25 , 26 , 30 , 32 , 33 ] rather than the posterior (26%, n = 8) [ 4 , 8 , 10 , 11 , 14 , 24 ] pituitary lobes. Interestingly, both lobes were affected in 22% of cases (n = 7) [ 6 , 18 , 20 , 27-29 , 31 ]. Similarly, our 3 patients had anterior and posterior involvement.…”

Section: Discussionmentioning

confidence: 99%

Pituitary Infiltration by Lymphoma

Tovar-Méndez

Cuenca

Gómez-Pérez

et al. 2022

Journal of the Endocrine Society

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Lymphoma infiltration to pituitary is rare. It represents <0.5% of all reported pituitary metastasis. Here we present a case series of three patients with pituitary metastases from a systemic lymphoma. Also, we performed a literature review of the cases reported. We identified additional 31 cases where non-Hodgkin's lymphoma (NHL) was the most common (n = 28, 90%), with large B-cell NHL the most frequent histological subtype (n = 14, 45%). Central hypothyroidism (n = 21, 67%) was the most frequent pituitary deficiency followed by adrenal insufficiency (n = 19, 61%), and diabetes insipidus (n = 18, 58%). Full endocrine recovery was found in only 12% (n = 4) of patients after treatment, and the MRI showed tumor regression in 22% of them. In our series, two patients were diagnosed with diffuse large B-cell lymphoma, and one had mixed cellularity of classical Hodgkin lymphoma. The mean age was 54 ± 6.92 years. Hypopituitarism and diabetes insipidus were present in all of them, with 100% of mortality because of the advanced systemic disease.

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“…In our study, there were four sinonasal metastatic cases originating from the stomach and three cases from the liver, making gastrointestinal adenocarcinoma and hepatocellular carcinoma the top two common primary tumors. Previous cases have been largely reported in the Western literature [5,6,20,21,22,23,24,25]. However, the incidence and distribution of malignant tumors might be diverse between different geographic areas due to distinct genetic or environmental factors [26].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

Chang

Kuo

et al. 2019

JCM

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Extranasal cancers that metastasize to the sinonasal cavity are very rare. To date, there are only limited reports regarding this rare condition within the literature. Therefore, we retrospectively reviewed all patients diagnosed with metastatic cancer of the sinonasal tract from 2003 to 2018 at a tertiary academic medical center. Patient demographic data, clinical presentation, treatment modalities, and outcomes were investigated. There were a total of 17 patients (9 males and 8 females) included in the analysis. The mean age was 56.8 years (range 27–80). The most common primary malignancies were hepatocellular carcinoma (n = 3) and gastrointestinal tract adenocarcinoma (n = 3). The most common site of metastasis was the nasal cavity (n = 8). Five patients received radical tumor resection and the others underwent radiotherapy, chemotherapy, or combined chemoradiotherapy. The 2-year survival was 28%. In summary, metastasis to the sinonasal cavity remains extremely rare. A high degree of suspicion regarding the possibility of metastatic spread to the sinonasal region is necessary for patients with a previous history of malignancy who present with new sinonasal symptoms. The treatment strategy of sinonasal metastatic cancer is usually palliative therapy and the prognosis remains poor. However, early detection and diagnosis, coupled with aggressive treatment, may improve patient quality of life.

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Hypophyseal metastases: A report of three cases and literature review

Cited by 20 publications

References 23 publications

Management of Hypopituitarism

Management of Hypopituitarism

Pituitary Infiltration by Lymphoma

Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

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