Pituitary metastases as a rare variant of intracranial metastasis

Abstract

Metastatiс spread of neoplasms to the pituitary gland is a relatively common finding in autopsy series of cancer patients. The majority of these patients were asymptomatic. Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland. From 1993 through 2008, 3 patients with symptoms arising from tumor metastasis to the pituitary gland were evaluated at the Russian Polenov Neurosurgical Institute.Breast and lung cancers are the most common diseases that metastasize to the pituitary.In two patients, the primary malignancy was breast. In one case, the primary tumor was lung. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia were the most commonly reported symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved.