Transarterial Embolization With Use of Lipiodol and Gelatin Sponge for Active Nasal Bleeding From Hepatocellular Carcinoma Metastasis in the Pituitary Gland  -Case Report-

Takigawa, Tomohiro; Matsumaru, Yuji; Hayakawa, Masayuki; Ikeda, Kenji; Matsumura, Akira

doi:10.2176/nmc.51.592

Cited by 9 publications

(6 citation statements)

References 19 publications

(31 reference statements)

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“…Mishima et al presented a case that was initially diagnosed as a pituitary adenoma by three different pathologists but was later confirmed to be PM after the patient presented with hypovolemic shock due to massive nasal bleeding, highlighting the aggressive behavior of the tumor, which showed immediate regrowth after resection [20]. A similar pattern of regrowth after resection was observed by Tamura et al and Takigawa et al, in which patients presented with severe nasal hemorrhage requiring admission due to severe hypovolemia, which could not be explained by a recurrent pituitary adenoma [15,16].…”

Section: Discussionsupporting

confidence: 58%

“…All patients except one [18], who was in a terminal stage, received surgery through a transsphenoidal resection. In all patients, surgery was both therapeutic and diagnostic, but data are not conclusive to determine if this should be the only approach for these patients given its aggressive nature and fast recurrence in some cases [15,16,20]. Takigawa et al successfully treated massive nasal bleeding with embolization through the internal maxillary artery feeding the PM.…”

Section: Author/yearmentioning

confidence: 99%

“…Further symptoms include nerve palsies (N III, IV, and VI) and pituitary insufficiencies. There have been approximately 15 cases of PMs from HCC reported worldwide [10,11,12,13,14,15,16,17,18,19,20,21]. This article presents a case of PM as the initial manifestation of HCC in a 75-year-old female patient, which is only the third reported case in women worldwide.…”

Section: Introductionmentioning

confidence: 97%

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Pituitary metastasis arising from hepatocellular carcinoma: a case report and update of the literature

Rodriguez,

Vogel,

Dreher

et al. 2024

Z Gastroenterol

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Hepatocellular carcinoma (HCC) is the sixth most common neoplasia and the third leading cause of cancer-associated deaths worldwide. Most cases arise in patients with cirrhosis, and early detection through periodic screening can make it potentially curable. The presence of extrahepatic metastases (EHM) affects treatment decisions and curability. The lungs are the most common site for EHM, followed by lymph nodes, bones, and the adrenal glands. Interestingly, approximately only 15 cases of HCC metastasizing to the pituitary gland have been reported so far.The most common symptoms of pituitary metastasis (PM) arising from HCC are nerve palsies affecting the third, fourth, and sixth cranial nerves. Other symptoms, such as diabetes insipidus or pituitary insufficiencies, are present in a minority of cases. Detecting PM is difficult given its rarity. Gold-standard treatments for these patients have not yet been established, but the prognosis is dismal, with a median overall survival of only 4.5 months. In this paper, we present an interesting case of PM as the first symptom of an HCC in a 75-year-old female. We also present an overview of all cases reported to date with emphasis on symptom presentation and survival after diagnosis.Given the improvement of systemic therapy, more cases are diagnosed in both oligometastatic and palliative conditions. Therefore, better approaches and treatment modalities for extrahepatic metastases due to HCC should be defined.

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Section: Discussionsupporting

confidence: 58%

Section: Author/yearmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Pituitary metastasis arising from hepatocellular carcinoma: a case report and update of the literature

Rodriguez,

Vogel,

Dreher

et al. 2024

Z Gastroenterol

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“…Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are commonly adopted LRTs. There are two successful reports of TACE application to control active nasal bleeding postoperatively ( 34 , 35 ), which implies a potential application of endovascular management in PMs. Sorafenib, a tyrosine kinase inhibitor (TKI), is the first drug approved for HCC systemic therapy.…”

Section: Discussionmentioning

confidence: 99%

A rare case of pituitary metastasis from hepatocellular carcinoma: case report and literature review

Cheng

Feng

2023

Front. Oncol.

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Presence of pituitary metastases (PMs) is a relatively rare clinical situation, especially when originating from hepatocellular carcinoma (HCC). A 73-year-old man presented with headaches, diplopia, and soon impaired vision, as well as gastrointestinal symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain revealed a space-occupying mass in the sellar region. The patient had a history of hepatocellular carcinoma and recent abdominal ultrasound and positron emission tomography (PET) indicated recurrence and metastases. Endoscopic transnasal transsphenoidal tumor excision was performed, and postoperative pathological report confirmed the diagnosis of HCC PM. In the literature review, 17 published cases of HCC PMs were summarized. Both the diagnosis and management of HCC PMs are difficult. Patients who had HCC-related history and new-onset headaches or diplopia should be inspected with a suspicion of metastatic lesions. Surgical intervention with transnasal endoscope is only recommended to ameliorate the symptoms and improve the life quality.

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“…The appearance order of symptoms in the natural course may be useful for the confirmative diagnosis. On the one hand, the initial clinical symptoms in the clinical course may be related to the central nervous system (3,(6)(7)(8)(9)(10). Six cases have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Pituitary metastasis of hepatocellular carcinoma as the initial presentations: a case report and review of the literature

Feng

Cai

et al. 2023

Front. Oncol.

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BackgroundExtrahepatic metastasis of hepatocellular carcinoma (HCC) is common. However, pituitary metastasis of HCC is extremely rare. Our case may be helpful to extend the understanding of the disease.Case presentationA 65-year-old man presented to the outpatient department for unexplained headache and ptosis for 1 month. Brain imaging showed a slight enhancement tumor in the pituitary fossa, and the endocrinological assessment showed normal results. We considered the tumor as a non-functioning pituitary adenoma before surgery. Then, the tumor was resected by an endonasal endoscopic transsphenoidal approach. The histopathological examination results revealed the pituitary metastasis of HCC. Additional abdominal imaging revealed tumors were located in the left and right liver lobes with portal vein invasion and bilateral ilium metastases. After multidisciplinary cooperation, the patient chose chemotherapy.ConclusionWe report a case of HCC metastasis to the pituitary gland that initially presented with neurological symptoms. We should consider the possibility of pituitary metastasis in HCC patients.

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Transarterial Embolization With Use of Lipiodol and Gelatin Sponge for Active Nasal Bleeding From Hepatocellular Carcinoma Metastasis in the Pituitary Gland -Case Report-

Cited by 9 publications

References 19 publications

Pituitary metastasis arising from hepatocellular carcinoma: a case report and update of the literature

Pituitary metastasis arising from hepatocellular carcinoma: a case report and update of the literature

A rare case of pituitary metastasis from hepatocellular carcinoma: case report and literature review

Pituitary metastasis of hepatocellular carcinoma as the initial presentations: a case report and review of the literature

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