Metastatic carcinoma to pituitary adenoma report of two cases

doi:10.1016/0090-3019(88)90301-1

Surgical Neurology

Volume 30, Issue 4, October 1988, Pages 286-292

https://doi.org/10.1016/0090-3019(88)90301-1 Get rights and content

Abstract

The authors present two patients with symptomatic carcinomas which have metastasized to pituitary adenomas. Despite the advanced age of these patients, the preoperative clinical and radiologic evaluations were consistent with pituitary adenoma. There was no previous history of malignancy in either patient, and the symptomatic pituitary metastases were responsible for the initial presentations. A review of the literature is presented with emphasis on the incidence and possible factors responsible for tumors metastasizing to distant neoplasms.

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A pituitary metastasis, an adenoma and potential hypophysitis: A case report of tumour to tumour metastasis in the pituitary
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Citation Excerpt :
References cited in the articles identified were also assessed for relevance. Our literature review identified 28 reported cases of metastases to pituitary adenomas [5,8–30], shown in Table 1, most previously described by Noga et al, Hoellig et al and Yang et al. [15,21,29]. The average patient age was 66 years, with an almost equal spread of males to females (52%F, 48%M).
Tumour to tumour metastasis is a rare event, especially in the pituitary. Metastases to pituitary adenomas most commonly occurs in late stage disease, commonly presenting with visual field defects and adenohypophyseal dysfunction. The most frequent primary cancers are lung, breast and renal carcinoma which deposit most commonly in prolactinomas, somatotropinomas, gonadotropinomas. In nearly 40% of cases, sellar symptoms are the harbinger to the diagnosis of primary malignancy. The abnormal vascularity and growth promoting microenvironment of pituitary adenomas may encourage metastatic seeding and proliferation of these “collision tumours”. Here, we present a case of a breast carcinoma metastasis to a pituitary null-cell adenoma in the setting of immunotherapy. Infundibular thickening in the setting of immunotherapy is often ascribed to hypophysitis, but our case highlights that metastatic spread should be part of the differential diagnosis.
Colon metastasis to residual pituitary macroadenoma causing accelerated growth: Case report and review of the literature
2017, Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
Citation Excerpt :
Only a handful of case reports have been published in literatures. From PubMed online database search, we found 26 published cases of pituitary metastasis to PA [6,10–30] (Table 1). Five of twenty-six of these reports (20%) were from autopsy findings without patients' actual PA surgery when they were alive.
Metastasis to post-surgical pituitary adenoma (PA) is extremely rare.
A 53-year-old man previously underwent endoscopic transsphenoidal surgery (TSS) for resection of PA and had stable annual post-operative magnetic resonance imaging for several years. Later, he had abdominal surgery for newly discovered malignant colon neoplasm. In addition, evidence of multiple lung metastases was subsequently discovered prompting chemotherapy. The patient, before his second TSS, presented with symptomatic visual field defect from rapidly enlarging residual PA causing mass effect to optic apparatus. Subsequently, second operation was performed with unremarkable intraoperative findings and postoperative course. However, histopathology revealed metastatic adenocarcinoma inside the PA.
This is the first reported case of metastasis from colon cancer to post-TSS PA.
Pituitary metastases: What is the role of surgery?
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2011, The Pituitary
The pituitary gland, sella turcica and the parasellar region can be involved by a wide variety of nonneoplastic tumor-like lesions as well as by numerous benign and malignant neoplasms. In cancer patients, metastasis to the pituitary gland is more common than pituitary adenoma. Metastases are also the most frequent tumor of the eurohypophysis, which is affected about twice as often as the adenohypophysis. The prevalence of pituitary metastasis in autopsy series of cancer patients ranges up to 26.7% with most reports quoting around 3–5%. In an autopsy study of 739 cancer patients, one-half of the pituitary metastases constituted the only metastatic deposit in the CNS. Although any tumor can metastasize to the pituitary gland, carcinomas of the breast and lung account for 50% and 20% of cases respectively, based on a review of 220 cases by McCormick et al. This chapter provides a well-illustrated review of the sellar tumors.
Nonpituitary Tumors of the Sellar Region
2010, The Pituitary, Third Edition
The pituitary gland, sella turcica and the parasellar region can be involved by a wide variety of nonneoplastic tumor-like lesions as well as by numerous benign and malignant neoplasms. In cancer patients, metastasis to the pituitary gland is more common than pituitary adenoma. Metastases are also the most frequent tumor of the eurohypophysis, which is affected about twice as often as the adenohypophysis. The prevalence of pituitary metastasis in autopsy series of cancer patients ranges up to 26.7% with most reports quoting around 3–5%. In an autopsy study of 739 cancer patients, one-half of the pituitary metastases constituted the only metastatic deposit in the CNS. Although any tumor can metastasize to the pituitary gland, carcinomas of the breast and lung account for 50% and 20% of cases respectively, based on a review of 220 cases by McCormick et al. This chapter provides a well-illustrated review of the sellar tumors.
An unusual case of tumor-to-cavernoma metastasis. A case report and literature review
2006, Surgical Neurology
Metastases of systemic neoplasia to preexisting intracranial mass lesions are uncommon phenomena. Tumor-to-intracranial cavernoma metastases are even more unusual and rarely reported. We describe here a case of melanoma to intracranial cavernoma metastasis.
A 39-year-old woman presented after an episode of generalized tonic-clonic seizure on a background of infrequent epilepsy. She was found to have a left parieto-occipital hemorrhagic lesion on imaging studies. The lesion was surgically removed and histopathology showed a metastatic melanoma within a cavernoma.
This case report represents the third recorded case of tumor-to-intracranial cavernoma metastasis and the first melanoma to intracranial cavernoma metastasis. An extensive literature review of tumor-to-intracranial tumor metastases was conducted and disclosed an increase in reporting of the uncommon phenomenon of metastasis into preexisting intracranial lesions. It should therefore be considered as a differential diagnosis in patients with history of systemic cancer who present with progression of preexistent intracranial lesions.

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View full text

Metastatic carcinoma to pituitary adenoma report of two cases

Abstract

Lancet

Metastasis of prostate carcinoma to intracranial meningioma

Microadenoma of the pituitary and abnormal sella tomograms in an unselected autopsy series

N Engl J Med

Metastases to primary intracranial meningiomas and neurilemomas

Arch Pathol Lab Med

Subclinical adenoma of the pituitary gland

Am J Pathol

Metastasis of cancer to cancer

Arch Pathol

Tumors of the pituitary gland and infundibulum

Incidence and significance of multiple primary malignant neoplasms

Ann NY Acad Sci

Metastasis to pituitary adenoma

Arch Pathol Lab Med