Pituitary metastasis: is there still a place for neurosurgical treatment?

Gilard, V.; Alexandru, Cristina; Proust, F.; Derrey, Stéphane; Hannequin, P.; Langlois, Olivier

doi:10.1007/s11060-015-1967-y

Cited by 29 publications

(26 citation statements)

References 30 publications

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“…Resection alone, with or without radiotherapy, does not change survival rates (154). The median survival rate after surgical removal of the pituitary tumor is 6 months (155, 156). Review of the literature determined the mean survival post-Pit Met diagnosis was 13.6 months.…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastasis: a rare condition

Javanbakht

D’Apuzzo

Badie

et al. 2018

Endocrine Connections

135

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Tumor metastasis to the pituitary gland is a rare, not well-documented and life-threatening condition associated with a shortened life span. A better understanding of its clinical manifestations could lead to earlier diagnosis, appropriate therapy and potentially improving quality of life. Therefore, we retrospectively studied the charts of patients with pituitary metastases who were treated at the City of Hope National Medical Center (Duarte, CA) from 1984 to 2018. We reviewed and analyzed tumor origin, primary pituitary clinical manifestation, duration between primary tumor diagnosis and pituitary metastasis, type of treatment and patient survival. A total of 11 patients were identified with a mean age of 59.2 years and median survival following the diagnosis of metastasis of 10 months. Breast cancer and lymphoma were the most common primary origins in these cases, and diabetes insipidus and panhypopituitarism were the most common clinical manifestations of their metastasis. We also compared our results with reports in the literature published between 1957 and 2018. A total 289 patients with pituitary metastasis have been reported in the literature. Breast cancer was the most frequent primary origin of the metastasis, and visual symptoms were the most common primary manifestation. The posterior part of the pituitary is more susceptible than the anterior to metastasis. Pituitary metastasis may occur as a consequence of successful primary tumor treatment prolonging the chance of seeding. Future studies are needed to determine the molecular mechanism of metastasis to the pituitary.

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Section: Discussionmentioning

confidence: 99%

Pituitary metastasis: a rare condition

Javanbakht

D’Apuzzo

Badie

et al. 2018

Endocrine Connections

135

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“…In a review of the literature concerning 31 patients, Gilard et al observed that only 20% of patients appeared to be symptomatic [12]. As pituitary metastases often present in a disseminated cancer setting, characteristic clinical pituitary signs are usually overwhelmed by symptoms associated with concomitant extra-pituitary metastases [12]. …”

Section: Discussionmentioning

confidence: 99%

“…In the series of Gilard et al, oculomotor palsy occurred in 42% of patients with metastasis as compared to fewer than 5% of patients with pituitary adenomas [12]. …”

Section: Discussionmentioning

confidence: 99%

Pituitary Metastasis from Renal Cell Carcinoma: Description of a Case Report

et al. 2017

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Patient: Male, 61Final Diagnosis: Pituitary metastasis from renal cell carcinomaSymptoms: Deterioration of visual acuity and field • persisting headache • excess thirst • polyuriaMedication: —Clinical Procedure: Total body CT-scan • brain MRI • trans-sphenoidal endoscopical surgery • radiotherapy • anti-angiogenic therapySpecialty: OncologyObjective:Rare diseaseBackground:Pituitary metastasis is uncommon, breast and lung cancers being the most frequent primary tumors. Renal cell carcinoma (RCC) is a rare cause of pituitary metastases, with only a few cases described to date.Case Report:We report a case of a 61-year-old man who presented with a progressive deterioration of visual acuity and field associated with a bitemporal hemianopsia. Two years ago, he underwent radical right nephrectomy for a clear cell RCC (ccRCC). The biological tests showed pan-hypopituitarism and diabetes insipidus. Brain MRI revealed a large sellar tumor lesion bilaterally infiltrating the cavernous sinuses, which was surgically resected. Histology confirmed a ccRCC pituitary metastasis. The patient received post-surgical radiotherapy. Considering the presence of concomitant extra-pituitary metastases, treatment with sunitinib was started, followed by several lines of therapy with axitinib, everolimus, and sorafenib because of tumor progression. The patient also presented with a pituitary tumor recurrence, which was treated by stereotaxic radiotherapy. He died five years after the initial diagnosis of RCC and 30 months after the diagnosis of the pituitary metastasis.Conclusions:There are no standardized treatment guidelines for management of pituitary metastases. Pituitary surgery plays a role in symptom palliation, and it does not have any relevant impact on survival. Exclusive radiotherapy or stereotaxic radiotherapy could be an alternative to surgery in patients whose general condition is poor or who have concomitant extra-pituitary metastases.

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“…За даними літератури, частота діагностуван-ня вторинних уражень гіпофіза -від 1 до 19% [8,9]. Відзначено, що у разі виявлення за даними нейрові-зуалізації пухлинного утворення в селярній ділянці та за наявності онкологічного анамнезу це утворення в 90% випадків є метастазом [10][11][12][13]. Частота мета-стазів у гіпофіз, які дають симптоматику, становить від 4,5 до 3,0% [13][14][15][16].…”

Section: украинский нейрохирургический журнал 2018;(1):78-83unclassified