title: Renal cell carcinoma metastatic to the pituitary gland: clinical manifestations and successful treatment with transsphenoidal resection.
abstract: OBJECTIVE
  To describe two cases of metastatic involvement of the pituitary gland by renal cell carcinoma (RCCA) and review the medical literature regarding this entity.
  
  
  METHODS
  We present two case reports and discuss the published literature to illustrate the clinical findings, radiographic features, and recommended management of RCCA metastatic to the pituitary gland.
  
  
  RESULTS
  During a 12-month period, we encountered two patients, one with visual deficits and both with anterior pituitary dysfunction, who had large sellar lesions that were histologically proved to be RCCA. Both patients were successfully treated with transsphenoidal surgical resection of the lesion, one of whom is alive and well more than 2 years later. A pituitary metastatic tumor is an uncommon complication of RCCA; it may be difficult to diagnose and potentially fatal. Anterior pituitary dysfunction and visual disturbances are more common initial features than is diabetes insipidus, in contrast to pituitary metastatic involvement from other tumors.
  
  
  CONCLUSIONS
  Transsphenoidal resection is a safe and effective method of treatment of RCCA metastatic to the pituitary gland.
authors.affiliation: Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: I E
authors.initials: IE
authors.lastname: Marar
authors.forename: H
authors.initials: H
authors.lastname: Kandil
authors.forename: E
authors.initials: E
authors.lastname: Kanal
authors.forename: D
authors.initials: D
authors.lastname: Marion
authors.forename: M
authors.initials: M
authors.lastname: Inman
authors.forename: J A
authors.initials: JA
authors.lastname: Amico