title: Pituitary gland metastasis from renal cell carcinoma presented as a non-functioning macroadenoma.
abstract: Metastatic tumors involving the pituitary gland are an uncommon finding and occur in up to 1% of all pituitary tumor resections. A 74-year-old man had progressive vision deterioration, over the 30 days prior to consultation. He did not complain of headache or polyuria, but referred to intestinal constipation. Five years ago, he underwent a right radical nephrectomy for renal cell carcinoma, followed by chemotherapy and radiotherapy for lung and parotid metastases. On ophthalmologic examination, there was a left abducens nerve palsy and bitemporal hemianopia. Magnetic resonance imaging demonstrated a sellar mass with suprasellar cistern extension compressing the optic chiasm. Endocrinological evaluation revealed central adrenal and gonadal insufficiencies. The patient underwent a transsphenoidal tumor resection that revealed renal cell carcinoma. This case illustrates that metastatic pituitary lesions can mimic typical symptoms and signs of pituitary macroadenoma. Furthermore, clinical diabetes insipidus, a common finding of pituitary metastases, can be absent.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. carolinekkramer@gmail.com
authors.forename: Caroline Kaercher
authors.initials: CK
authors.lastname: Kramer
authors.forename: Nélson
authors.initials: N
authors.lastname: Ferreira
authors.forename: Sandra Pinho
authors.initials: SP
authors.lastname: Silveiro
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Gross
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Dora
authors.forename: Mirela Jobim de
authors.initials: MJ
authors.lastname: Azevedo
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery