[Apoplexy in pituitary metastasis of renal cell carcinoma. Clinical case followed for 7 years].
We report a man in whom a 15 cm. renal tumor was excised at the age of 49. The pathological examination showed a clear cell carcinoma. Five years later, he presented with headache, vomiting and unilateral palpebral ptosis. Imaging studies showed a sellar tumor with pituitary apoplexy. The tumor was excised and the pathological study disclosed a clear cell tumor, positive for vimentin, cytokeratins AE1 and AE3 and immunohistochemically negative for LH, TSH, ACTH and GH. Considering the similar histopathological features, it was considered as a metastasis of the renal tumor. The patient was supplemented with thyroid, adrenal and gonadal hormones. Seven years later, he presented a new tumor in the remaining kidney, that corresponded to a cystic papillary renal cell carcinoma. Afterwards, he presented a transitional urinary bladder tumor. Mortality associated to renal cell tumors is 90% at 5 years, and pituitary metastases are extraordinarily uncommon.
Quevedo
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I
Departamento de Endocrinología y Anatomía Patológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Centro Médico Monseñor Carlos, Casanueva, Santiago de Chile.
Rodríguez Portales
J A
JA
Rosenberg
H
H
Mery
J
J
D018262:Adenocarcinoma, Clear Cell / Q000556:secondary* / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery