Pituitary gland metastasis from renal cell carcinoma presented as a non-functioning macroadenoma.
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.
Kramer
Caroline Kaercher
CK
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. carolinekkramer@gmail.com
Ferreira
Nélson
N
Silveiro
Sandra Pinho
SP
Gross
Jorge Luiz
JL
Dora
José Miguel
JM
Azevedo
Mirela Jobim de
MJ
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