[Pituitary metastases in patients with prior neoplasms].
The pituitary is an uncommon site for metastases. We report three cases of patients with a history of cancer (breast and lung) who presented with symptoms of headache, ophthalmoplegia, fatigue, diabetes insipidus, nausea, and vomiting. Cranial magnetic resonance imaging was performed, revealing sellar masses with infiltration of the adjacent tissues compatible with pituitary metastases in all three patients. In two of the patients, hormonal analyses were performed, which showed anterior pituitary insufficiency (thyroid-stimulating hormone and adrenocorticotropic hormone deficiency), symptoms which improved with hormone replacement therapy. Other treatments applied were surgery, radiotherapy and chemotherapy, which show no association with increased survival rates but are able to improve symptoms. The prognosis in all patients was poor. The patients developed further metastases and two died soon after diagnosis. Pituitary function study should be performed in patients with a previous neoplasm and symptoms compatible with hormonal dysfunction or local compressive symptoms.
Frago Marquínez
Itziar
I
Servicio de Medicina Interna, Hospital Txagorritxu, Vitoria-Gasteiz, Alava, Spain. ifrago@yahoo.es
Fuentes Gómez
Clara
C
Maldonado Castro
Gonzalo
G
Puelles Emaldibarra
Nagore
N
San Miguel López de Uralde
Sonia
S
Echeveste Aizpurua
Jon
J
Arroita González
Gorka
G
D000230:Adenocarcinoma / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D016371:Cranial Irradiation; D003919:Diabetes Insipidus / Q000209:etiology; D004172:Diplopia / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006261:Headache / Q000209:etiology; D020249:Hormone Replacement Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010166:Palliative Care; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D011379:Prognosis