title: Multimodal treatment of hemorrhagic pituitary metastasis as first manifestation of renal cell carcinoma.
abstract: BACKGROUND
  Metastatic tumors involving the pituitary gland are very rare, with only few cases reported so far in the literature.
  
  
  METHODS
  We report a case of a man who presented with an extremely vascular hemorrhagic pituitary metastasis as the first manifestation of renal cell carcinoma. The patient was successfully treated with staged procedures, including preoperative tumor vasculature embolization followed by transsphenoidal tumor resection.
  
  
  CONCLUSIONS
  This is the first report describing multimodality treatment of a patient with pituitary metastasis of unknown origin requiring presurgical embolization before successful tumor removal.
authors.affiliation: Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel. rachelgr@tasmc.health.gov.il
authors.forename: Rachel
authors.initials: R
authors.lastname: Grossman
authors.forename: Shimon
authors.initials: S
authors.lastname: Maimon
authors.forename: Ronen
authors.initials: R
authors.lastname: Levite
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
mesh_terms: D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D004724:Endoscopy; D006801:Humans; D007016:Hypophysectomy; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D007680:Kidney Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D009392:Nephrectomy; D010911:Pituitary Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed