title: A metastatic pituitary carcinoid tumor successfully treated with gamma knife radiosurgery.
abstract: Intracranial metastasis occurs in a certain number of patients with carcinoid tumor. However, carcinoid tumor with metastasis to the pituitary gland is extremely rare. Up to the present, no effective treatment for either a metastatic intracranial carcinoid tumor or a metastatic pituitary lesion of any origin has been documented. We have treated a case of metastatic carcinoid tumor of the pituitary gland with transsphenoidal tumor resection followed by gamma knife radiosurgery. A 59-year-old man presented with headache and left oculomotor palsy. He was treated at the same hospital for bronchial atypical carcinoid tumor one and a half years ago. Magnetic resonance image of the brain showed a pituitary tumor. There were no signs of recurrent or metastatic lesion elsewhere despite thorough investigation. Transsphenoidal approach for removal of tumor was done and the pathology turned out to be a metastatic carcinoid tumor. Subsequent gamma knife radiosurgery was given for residual tumor. The oculomotor palsy improved after radiosurgery. No neurological deficit occurred. Follow-up CT scan of the brain showed complete resolution of the tumor. We concluded that gamma knife radiosurgery could be used to treat a metastatic intracranial carcinoid tumor. It can also be used to treat a metastatic lesion of the pituitary gland without causing neurological deficit.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. muhuang@vghtpe.gov.tw
authors.forename: M C
authors.initials: MC
authors.lastname: Huang
authors.forename: L S
authors.initials: LS
authors.lastname: Lee
authors.forename: D M
authors.initials: DM
authors.lastname: Ho
authors.forename: H
authors.initials: H
authors.lastname: Cheng
authors.forename: W Y
authors.initials: WY
authors.lastname: Chung
authors.forename: C I
authors.initials: CI
authors.lastname: Huang
authors.forename: C Y
authors.initials: CY
authors.lastname: Hsiao
authors.forename: D H
authors.initials: DH
authors.lastname: Pan
mesh_terms: D002276:Carcinoid Tumor / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed