Synchronous bifocal metastatic involvement of pituitary and pineal glands unmasking small cell lung cancer

Little, Eric W; Kazmi, Khuram; Queenan, Joseph V.; Katsetos, Christos D.

doi:10.5414/np300918

Cited by 2 publications

(3 citation statements)

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“…A total of 16 patients with pituitary metastasis were reported in the previous 10 years. (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) The collected information and primary lesion data are presented in Table I. The average age of all patients was 61.5 years, and the number of females was twice as high as that of males (11:5).…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastasis in breast cancer: case report and literature review

Sha¹,

Zhang²,

Chen³

et al. 2020

Preprint

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Background: Breast cancer commonly metastasizes to the lung, vertebrae or liver but rarely to the pituitary gland. The majority of cases have been reported during autopsy; however, with the improvements in diagnostic methods, there has been an increasing number of cases reported in the clinical setting. The main symptoms of pituitary metastasis are reported to be headache, diabetes insipidus and visual field defects, which may cause confusion regarding the clinical diagnosis.Case presentation: The present study describes a case of pituitary metastasis symptoms of diabetes insipidus and loss of vision in a patient with breast cancer. After the patient completed the evaluation, a neuroendoscopy-assisted endonasal transsphenoidal tumor resection was performed. The postoperative biopsy revealed metastatic breast cancer.Conclusions: The present study analyzed this patient and 16 other cases of pituitary metastases collected from the PubMed database. Lung cancer, breast cancer and lymphoma could metastasize to the sellar region, while certain other tumors from the liver, parotid, colon, prostate, stomach, kidney, thyroid or skin were also observed. The clinical manifestation was often dominated by pituitary dysfunction, intracranial hypertension and visual field defects. Certain patients may suffer from oculomotor nerve paralysis, electrolyte imbalance, diabetes insipidus or a loss of vision. Imaging findings revealed that sellar metastases often invaded the suprasellar region. In a few cases, the lesion enclosed intracranial vessels, and invaded the cavernous sinus or Meckel's cave. These characteristics resulted in difficulties during surgery.

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Section: Discussionmentioning

confidence: 99%

Pituitary metastasis in breast cancer: case report and literature review

Sha¹,

Zhang²,

Chen³

et al. 2020

Preprint

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“…Four radiological reports [ 11 , 19 , 21 , 28 ] described a thickening or an involvement of the pituitary stalk. In a minority of patients, the authors reported the involvement of other encephalic structures, such as the compression of the third ventricle (n = 4) [ 22 , 25 , 36 , 39 ], of the optic nerve (n = 2) [ 13 , 25 ] or the extension into the prepontine and premesencephalic cisterns (n = 1) [ 22 ].…”

Section: Literature Reviewmentioning

confidence: 99%

“…The pituitary mass was associated to other central nervous system (CNS) metastatic lesions in 17% of cases. Moreover, a rapid PM growth was reported in three patients who performed two MRI scans at a close time interval [ 6 , 36 , 41 ]. Two PM appeared calcified [ 6 , 40 ] and one caused a fibrotic reaction around the sella turcica [ 23 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Pituitary metastases from neuroendocrine neoplasms: case report and narrative review

et al. 2021

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Purpose Pituitary metastases (PM) are uncommon findings and are mainly derived from breast and lung cancers. No extensive review of PM from neuroendocrine neoplasms (NENs) is on record. Here we describe a clinical case of PM from pancreatic NEN and review the clinical features of PM from NENs reported in the literature. Methods A case of PM from a pancreatic NEN followed at our institution is described. We also reviewed the 43 cases of PM from NENs reported in the literature. Results A 59-year old female patient, previously submitted to duodeno-cephalo-pancreasectomy for a well-differentiated pancreatic NEN, with known hepatic metastases, underwent a 68 Ga-DOTATOC PET/CT that revealed an uptake in the pituitary gland. A subsequent MRI displayed a pituitary lesion, with suprasellar extension. After a hormonal and genetic diagnostic workup that excluded the diagnosis of MEN 1, the worsening of headache and visual impairment and the growth of the lesion lead to its surgical removal. A pituitary localization of the pancreatic NEN was identified. Regarding the published cases of PM from NENs, the most common tumour type was small cell lung cancer (SCLC), accounting for nearly half of the cases, followed by bronchial and pancreatic well differentiated NENs. The most frequent symptom was a variable degree of visual impairment, while headache was reported in half of the cases. Partial or total anterior hypopituitarism was present in approximately three quarters of the cases, while diabetes insipidus was less common. The most frequent treatment for PM was surgical resection, followed by radiotherapy and chemotherapy. The clinical outcome was in line with previous reports of PM from solid tumours, with a median survival of 14 months. Surgery of PM was associated with prolonged survival. Conclusions PM from NENs have clinical features similar to metastases derived from other solid tumours, albeit the involvement of the anterior pituitary seems more frequent; a thorough pituitary hormonal evaluation is mandatory, after focused radiological studies, particularly if a surgical approach is considered. The optimal management of PM remains disputed and seems mainly driven by the aggressiveness of the primary tumour and the presence of symptoms. In well-differentiated NENs, particularly in the case of symptomatic PM, surgical removal may be a reasonable approach.

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Synchronous bifocal metastatic involvement of pituitary and pineal glands unmasking small cell lung cancer

Cited by 2 publications

References 0 publications

Pituitary metastasis in breast cancer: case report and literature review

Pituitary metastasis in breast cancer: case report and literature review

Pituitary metastases from neuroendocrine neoplasms: case report and narrative review

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