Pituitary metastasis

Max, Mitchell B.; Deck, Michael D. F.; Rottenberg, David A.

doi:10.1212/wnl.31.8.998

Cited by 252 publications

(167 citation statements)

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“…1,15,19 If one considers autopsy series in which both the pituitary and surrounding sella turcica have been evaluated, however, rates of metastasis as high as 27% have been reported to occur in this area.…”

Section: Prevalence Of Pituitary Metastasesmentioning

confidence: 99%

Metastases to the pituitary gland

Fassett

Couldwell

2004

FOC

198

182

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Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience 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. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

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Section: Prevalence Of Pituitary Metastasesmentioning

confidence: 99%

Metastases to the pituitary gland

Fassett

Couldwell

2004

FOC

198

182

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“…Four of the 12 reported patients had diabetes insipidus, which occurs in only 1% to 2% of patients with pituitary adenomas. 15,17) This finding may reflect the propensity for pituitary metastases to localize in the posterior lobe of the pituitary gland. 5,9) In addition, nine patients, including the present patient, showed hypopituitarism and complained of general fatigue, nausea, and appetite loss.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of hypophyseal metastases ranged from 1% to 25% at autopsy in patients with systemic cancer. 4,12,15) High frequencies of metastasis were found in histological specimens obtained at hypophysectomy in patients with advanced mammary carcinoma. 5,7,8,11) Therefore, most metastatic pituitary tumors seem to occur as part of widespread systemic metastasis.…”

Section: Introductionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma Mimicking Pituitary Adenoma-Case Report-

Yamaki

Oka

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A 54-year-old man, with a past history of renal cell carcinoma, presented with bitemporal visual field defect, hyponatremia, and diabetes insipidus. Endocrinological examination revealed panhypopituitarism. Computed tomography and magnetic resonance imaging showed an intrasellar mass with suprasellar extension. The initial radiological impression was pituitary adenoma. The tumor was decompressed via the transsphenoidal route. Histological examination revealed metastatic renal cell carcinoma. The clinical characteristics of metastatic pituitary carcinoma appear to be panhypopituitarism, and neuroimaging findings of strong enhancement of the tumor and bony destruction without marked sellar enlargement.

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“…[36][37][38][39][40][41][42] The most common tumors which metastasize to the pituitary gland are lung and breast cancer. [43][44][45][46][47][48][49][50][51] Most often, they are part of the generalized metastatic spread, usually associated with more than one metastatic site, particularly osseous.…”

Section: Sellarmentioning

confidence: 99%

Granular cell tumor of the neurohypophysis: Report of a case with intraoperative cytologic diagnosis

Policarpio‐Nicolas

Mandell

et al. 2007

Diagnostic Cytopathology

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Cytological techniques including touch and smear preparations are very useful diagnostic modality in the evaluation of central nervous system (CNS) lesions and, in many instances, may be effectively used as the sole modality of tissue preparation for intraoperative consultation. Cytologic preparations offer many advantages over frozen sections for CNS specimens. These include selective examination of multiple areas from small biopsy specimens, superior preservation and details of cellular morphology, fewer artifacts, faster results, and improved costeffectiveness. We describe the cytologic diagnosis of a granular cell tumor (GCT) of the neurohypophysis in a 33-year-old male who presented with headache and blurred vision. CT scan revealed an enlarged sella with a 2.15 3 2.0 cm pituitary lesion. Transsphenoidal resection of the mass was performed and submitted for intraoperative consultation. Smears and touch preparations were made on a portion of the mass that showed uniform polygonal cells with round to ovoid nuclei and abundant eosinophilic granular cytoplasm. An intraoperative cytological diagnosis of ''favor GCT'' was rendered. The histologic sections of the remaining material confirmed the diagnosis. Although GCT of the neurohypophysis is very rare, a specific intraoperative cytological diagnosis is possible. We report the clinical, cytological, and pathological findings of a GCT affecting the neurohypophysis. Diagn. Cytopathol. 2008;36:58-63. ' 2007 Wiley-Liss, Inc.Key Words: granular cell tumor; neurohypophysis; intraoperative smear preparation Granular cell tumors (GCTs) have been reported in many sites of the body including the breast, skin, and larynx. However, head and neck have been the most common sites. GCT has a distinctive appearance on cytology, so that it has been suggested to be an effective method for accurate diagnosis even though some reports focus on the difficulties in cytological differential diagnosis. [1][2][3][4][5][6] Within the central nervous system (CNS), GCTs usually occur as intrasellar and/or suprasellar mass arising from the neurohypophysis or infundibulum. On histologic sections and cytological smears, GCT is composed of nests of large cells with small round to oval nucleus and abundant granular eosinophilic cytoplasm, arranged as individual cells or in clusters. Although the cytology of GCT in other sites has been reported in the English literature, 7-17 to our knowledge, there has been no report on the intraoperative touch/squash cytology of this tumor. We report the first case of GCT of the neurohypophysis diagnosed on cytological preparations during an intraoperative consultation, illustrating the value of intraoperative cytology as a well recognized and reliable diagnostic modality for rapid interpretation and even classification of neuropathologic specimens. Case ReportThe patient is a 33-year-old male with history of progressively worsening headache for 2 years. He presented to our hospital for fever, severe headache, nausea, vomiting, and blurred vision. Cerebrospinal...

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Pituitary metastasis

Cited by 252 publications

References 0 publications

Metastases to the pituitary gland

Metastases to the pituitary gland

Metastatic Renal Cell Carcinoma Mimicking Pituitary Adenoma-Case Report-

Granular cell tumor of the neurohypophysis: Report of a case with intraoperative cytologic diagnosis

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