title: Pituitary metastasis from breast cancer presenting as diabetes insipidus.
abstract: An 83-year-old woman developed pituitary metastasis while being treated for metastatic breast cancer. She presented with visual disturbance and headache followed by thirst, nocturia and polyuria. A visual field defect was present. MRI revealed a sellar mass consistent with metastasis to the pituitary gland. She was successfully treated with radiotherapy to the sella and had improvement of her visual symptoms and visual field defect. She then required ongoing treatment for diabetes insipidus. Her symptoms had not shown any sign of recurring up to 9 months after treatment. Pituitary metastases are rare but should be suspected in patients with metastatic cancer who present with features similar to those seen here. With improvements in survival in metastatic breast cancer, pituitary metastases may be seen more commonly and active local treatment is warranted given the possibility of resolution of symptoms related to the pituitary metastases.
authors.affiliation: Department of Medical Oncology, Mater Hospital, Sydney, New South Wales, Australia.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Gormally
authors.forename: Michael A
authors.initials: MA
authors.lastname: Izard
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Robinson
authors.forename: Frances M
authors.initials: FM
authors.lastname: Boyle
mesh_terms: D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000150:complications* / Q000556:secondary*; D003919:Diabetes Insipidus / Q000209:etiology*; D005260:Female; D006801:Humans; D010911:Pituitary Neoplasms / Q000150:complications* / Q000556:secondary*
references.citation: Eur J Endocrinol. 2007 Feb;156(2):203-16
references.pmid: 17287410
references.citation: J Neurosurg. 1998 Jul;89(1):69-73
references.pmid: 9647174
references.citation: J Neurosurg. 2004 Dec;101(6):1053-6
references.pmid: 15597769
references.citation: Cancer. 2004 Jan 1;100(1):44-52
references.pmid: 14692023
references.citation: Cancer. 1975 Jul;36(1):216-20
references.pmid: 1203849
references.citation: Neurology. 1981 Aug;31(8):998-1002
references.pmid: 7196526
references.citation: Endocrinol Metab Clin North Am. 2008 Mar;37(1):51-66, viii
references.pmid: 18226730
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):574-80
references.pmid: 14764764
references.citation: Neurosurg Focus. 2004 Apr 15;16(4):E8
references.pmid: 15191337
references.citation: J Clin Oncol. 2008 Oct 20;26(30):4891-8
references.pmid: 18725649
references.citation: Eur J Neurol. 2007 Jul;14(7):e11-2
references.pmid: 17594304
references.citation: Oncology. 1973;27(6):533-42
references.pmid: 4355105
references.citation: Cancer. 1983 Dec 15;52(12):2355-8
references.pmid: 6640507
references.citation: Arch Pathol Lab Med. 2008 Aug;132(8):1231-40
references.pmid: 18684022
references.citation: Neurol Med Chir (Tokyo). 2004 Mar;44(3):112-6; discussion 117
references.pmid: 15095963
references.citation: J Neurol Neurosurg Psychiatry. 2004 Sep;75 Suppl 3:iii47-52
references.pmid: 15316045
references.citation: Endocrinol Metab Clin North Am. 1999 Mar;28(1):81-117, vi
references.pmid: 10207686
references.citation: J Natl Cancer Inst. 2010 Apr 7;102(7):456-63
references.pmid: 20220104
references.citation: CA Cancer J Clin. 2013 Jan;63(1):11-30
references.pmid: 23335087
references.citation: Endocrinol Metab Clin North Am. 2008 Mar;37(1):67-99, viii
references.pmid: 18226731