Synchronous pituitary and pineal gland lesions presenting with panhypopituitarism in a patient with widespread colorectal cancer: a case report

Abstract

A 60-year-old man presented to our hospital because of febrile neutropenia due to chemotherapy for his metastasized colon cancer. During hospital stay, polyuria and polydipsia were noted. He reported that his thirst had become increasingly intolerable over the last weeks. Diabetes mellitus was diagnosed. Polyuria and polydipsia persisted despite euglycemia under insulin treatment. Because of thirst and high urine volumes during the night, diabetes insipidus was suspected. Endocrinological work up revealed complete panhypopituitarism with impairment of all anterior and posterior axes. After substitution with hydrocortisone, levothyroxine and desmopressin symptoms resolved. MRI of the brain revealed one round, contrast enhancing lesion in the pituitary stalk and one in the pineal gland. Because of extensive extracerebral metastasis and poor performance status, the patient opted for radiation therapy only. He died 2.5 months later due to non-cerebral manifestations of his cancer before cerebral radiotherapy could be initiated.

Impaired Neurodevelopmental Genes in Slovenian Autistic Children Elucidate the Comorbidity of Autism With Other Developmental Disorders

“…They cause dysregulation of the RAS-MaPK signaling pathway (Tartaglia et al, 2011) and are also linked to ID (Figure 3D). The maternally inherited pathogenic variant in the KRAS gene explains the panhypopituitarism observed in our patient (Patient 040110) (Struja and Capraro, 2021). Although the KRAS gene is not linked to ASD, ASD was observed in Patient 040110, presumed compound heterozygous variants in LZTR1 in Patient 029623, and a de novo variant in SOS2 in Patient 023509, are a probably causative in all three patients since ADHD and behavioral problems are reported in the Noonan syndrome phenotype (Roberts, 2001).…”

A rare case of metastatic colon cancer to the pineal region: A case report

“…[ 4 ] On the other hand, pineal region tumors account for <1% of all intracranial brain tumors with 0.4–3.8% of a metastatic origin. [ 6 ] In a study in 2006, ten patients were found to have metastatic pineal gland tumors. In those ten cases, six primary tumors were identified, three cases of lung cancer, and one case of each breast, renal, cervical, esophageal, gastric, and colon carcinomas.…”