Metastases to Pituitary: A Case Report and Review of Literature

Abstract

Pituitary metastasis (PM) secondary to systemic malignancies has been reported in the literature. Variety of clinical and neuroimaging presentation has been reported; however the diagnosis of PM is challenging. We report a case of a 44-year-old male with PM from non-small cell lung cancer (stage IV). He presented with sudden onset polyuria, polydypsia, and visual disturbance. Laboratory evaluation revealed pan-hypopituitarism and visual field test showed bitemporal lower quadrantanopsia. Brain magnetic resonance imaging demonstrated a suprasellar mass with focal hemorrhage and thickening of infundibular stalk. Surgical resection of the tumor followed by chemoradiotherapy was employed. Histopathologic examination of the tumor specimen revealed metastatic adenocarcinoma and immunostaning demonstrated findings consistent with lung carcinoma. Visual disturbances improved postoperatively and the patient is tumor free with no clinical or radiologic evidence of recurrence at 19 months of follow-up. The review of literature is included with the goal of elucidating the clinical presentation, imaging diagnosis, histogenesis, and the treatment strategies associated with the PM. © 2014 Wolters Kluwer Health, Inc. All rights reserved.