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Vol 50, No 6 (2016)

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Hypophyseal metastases: A report of three cases and literature review

Janez Ravnik1, Tomaz Smigoc1, Gorazd Bunc1, Bostjan Lanisnik2, Ursa Ksela3, Maja Ravnik4, Tomaz Velnar1
DOI: 10.1016/j.pjnns.2016.08.007
Neurol Neurochir Pol 2016;50(6):511-516.

Abstract

Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis. A transnasal endoscopic biopsy and resection of the tumour was performed in all patients, followed by the oncological treatment. Despite the rarity of the disease, it is important to suspect a metastatic pituitary tumour especially in the case of diabetes insipidus, ophthalmoplegia, rapid course of the disease and headaches. In 20–30% of patients, a metastasis to the pituitary is the first manifestation of a tumour of unknown origin. Surgical and adjuvant therapy may improve the quality of life. The survival is not affected, however, and the prognosis of the disease is usually poor.

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Neurologia i Neurochirurgia Polska