title: Metastatic pancreatic neuroendocrine tumor presenting as a pituitary space occupying lesion: a case report.
abstract: Neuroendocrine tumor metastases to the pituitary gland are very rare. There are few case reports of carcinoid tumor metastases to the pituitary, but no cases of pancreatic neuroendocrine pituitary metastases have been reported. In this report we present a 55-year-old female with a sellar mass, ophthalmoplegia and headaches initially thought to represent an invasive null cell pituitary adenoma. However a histological (trans-sphenoidal and liver biopsies) and systemic investigation proved it to be a metastasis of an undiagnosed pancreatic neuroendocrine tumor. Our patient was unique in respect to the location of the metastasis and the uncharacteristically high proliferative index of her tumor. She received conventional therapy consisting of Sandostatin, chemotherapy and radiotherapy as well as labeled somatostatin following an avid uptake on octreotide scanning. Despite a radiological improvement the patient suffered progressive clinical deterioration and died.
authors.affiliation: Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Chamutal
authors.initials: C
authors.lastname: Gur
authors.forename: Gadi
authors.initials: G
authors.lastname: Lalazar
authors.forename: Asher
authors.initials: A
authors.lastname: Salmon
authors.forename: Victoria
authors.initials: V
authors.lastname: Dubiner
authors.forename: David J
authors.initials: DJ
authors.lastname: Gross
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000628:therapy; D010911:Pituitary Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D015899:Tomography, Emission-Computed, Single-Photon