Pituitary apoplexy caused by hemorrhage from pituitary metastatic melanoma: case report.
Melanoma metastases to the pituitary gland are extremely rare, with only a few reported cases. We report an unusual case of pituitary metastatic melanoma in which the patient presented with pituitary apoplexy. A 68-year-old man presented general fatigue and anorexia following sudden headache. Neurological examination disclosed bitemporal hemianopsia. Computed tomography (CT) scans revealed a suprasellar mass including intratumoral hematoma. Magnetic resonance (MR) images demonstrated a circumscribed mass lesion in the intra- and suprasellar regions, compressing the optic chiasm. Surgical exploration was performed through a transsphenoidal approach, and a mixture of tumor and necrotic tissue with old hematoma was obtained. The histological examination of the specimen revealed a partly necrotic, malignant tumor with focal melanotic pigmentation. Histopathologically, the diagnosis was consistent with pituitary apoplexy caused by hemorrhage from pituitary metastatic melanoma.
Department of Neurosurgery, Osaka Police Hospital.
Katsuya
K
Masui
Taiji
T
Yonezawa
Yukei
Y
Shinji
Ryo
R
Nakano
Seisuke
S
Miyamae
D000368:Aged; D005773:Gastroscopy; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000098:blood supply / Q000150:complications / Q000556:secondary* / Q000601:surgery; D009336:Necrosis; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000473:pathology; D010899:Pituitary Apoplexy / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000098:blood supply / Q000150:complications / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology; D014057:Tomography, X-Ray Computed