scholarly journals Masked diabetes insipidus in pituitary metastasis from breast cancer after thalamic biopsy: a case report

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Hiroaki Hashimoto ◽  
Tomoyuki Maruo ◽  
Masami Nakamura ◽  
Yukitaka Ushio ◽  
Masayuki Hirata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diabetes Insipidus ◽  
Plasma Sodium ◽  
Case Presentation ◽  
Delayed Treatment ◽  
Pituitary Dysfunction ◽  
Asymptomatic Patients ◽  
Japanese Female ◽  
Old Japanese ◽  
Pituitary Metastasis

Abstract Background Symptomatic pituitary metastasis is rare; furthermore, it can result in diabetes insipidus and panhypopituitarism. Since diabetes insipidus is masked by concurrent panhypopituitarism, it can impede the diagnosis of pituitary dysfunction. Case presentation A 68-year-old Japanese female suffering from pituitary and thalamic metastases caused by untreated breast cancer, underwent a biopsy targeting the thalamus, not the pituitary. She lacked prebiopsy pituitary dysfunction symptoms; however, these symptoms unexpectedly occurred after biopsy. Diabetes insipidus was masked by corticosteroid insufficiency, and she showed normal urinary output and plasma sodium levels. Upon commencement of glucocorticoid replacement therapy, the symptoms of diabetes insipidus appeared. Conclusions In this case, thalamic biopsy, as opposed to pituitary biopsy, was performed to preserve pituitary function. However, pituitary dysfunction could not be avoided. Caution is necessary for asymptomatic patients with pituitary metastases as invasive interventions, such as surgery, may induce pituitary dysfunction. Moreover, with respect to masked diabetes insipidus, there is a need to carefully consider pituitary dysfunction to avoid misdiagnosis and delayed treatment.

Pituitary metastasis in breast cancer: case report and literature review

2020 ◽  
Author(s):  
Xiaosong Sha ◽  
Xiejun Zhang ◽  
Lei Chen ◽  
Jihu Yang ◽  
Guodong Huang
Keyword(s):  
Breast Cancer ◽  
Visual Field ◽  
Diabetes Insipidus ◽  
Diagnostic Methods ◽  
Electrolyte Imbalance ◽  
Visual Field Defects ◽  
Nerve Paralysis ◽  
Loss Of Vision ◽  
Field Defects ◽  
Pituitary Metastasis

Abstract Background: Breast cancer commonly metastasizes to the lung, vertebrae or liver but rarely to the pituitary gland. The majority of cases have been reported during autopsy; however, with the improvements in diagnostic methods, there has been an increasing number of cases reported in the clinical setting. The main symptoms of pituitary metastasis are reported to be headache, diabetes insipidus and visual field defects, which may cause confusion regarding the clinical diagnosis.Case presentation: The present study describes a case of pituitary metastasis symptoms of diabetes insipidus and loss of vision in a patient with breast cancer. After the patient completed the evaluation, a neuroendoscopy-assisted endonasal transsphenoidal tumor resection was performed. The postoperative biopsy revealed metastatic breast cancer.Conclusions: The present study analyzed this patient and 16 other cases of pituitary metastases collected from the PubMed database. Lung cancer, breast cancer and lymphoma could metastasize to the sellar region, while certain other tumors from the liver, parotid, colon, prostate, stomach, kidney, thyroid or skin were also observed. The clinical manifestation was often dominated by pituitary dysfunction, intracranial hypertension and visual field defects. Certain patients may suffer from oculomotor nerve paralysis, electrolyte imbalance, diabetes insipidus or a loss of vision. Imaging findings revealed that sellar metastases often invaded the suprasellar region. In a few cases, the lesion enclosed intracranial vessels, and invaded the cavernous sinus or Meckel's cave. These characteristics resulted in difficulties during surgery.

scholarly journals Pituitary metastasis from breast cancer presenting as diabetes insipidus

2014 ◽  
Vol 2014 (apr12 1) ◽  
pp. bcr2014203683-bcr2014203683 ◽  
Author(s):  
J. F. Gormally ◽  
M. A. Izard ◽  
B. G. Robinson ◽  
F. M. Boyle
Keyword(s):  
Breast Cancer ◽  
Diabetes Insipidus ◽  
Pituitary Metastasis

scholarly journals Valsalva-Like Retinopathy Spontaneously Occurred after Ocular Massage

2015 ◽  
Vol 6 (1) ◽  
pp. 88-92
Author(s):  
Keiko Uchida ◽  
Masayuki Takeyama ◽  
Masahiro Zako
Keyword(s):  
Vitreous Hemorrhage ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Yttrium Aluminium Garnet ◽  
Case Presentation ◽  
Vascular Abnormalities ◽  
Corrected Visual Acuity ◽  
Japanese Female ◽  
Old Japanese ◽  
Yttrium Aluminium Garnet Laser

Purpose: The aim of this study is to describe a case of Valsalva-like retinopathy that occurred after ocular massage. Case Presentation: A healthy 44-year-old Japanese female had massaged her eye with strong pressure several times. Subsequently, she noticed a loss in the left central vision. A left-eye fundus examination showed a dense preretinal hemorrhage located under the internal limiting membrane at the posterior pole and a mild vitreous hemorrhage. We performed a neodymium-doped yttrium-aluminium-garnet laser membranotomy to perforate the internal limiting membrane. Her best-corrected visual acuity improved from 0.01 to 1.0. No retinal vascular abnormalities in the macular area were found. Conclusion: Ocular massage can cause Valsalva-like retinopathy.

scholarly journals Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) and Subsequent Central Diabetes Insipidus: A Rare Presentation of Pituitary Apoplexy

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
S. B. Smedegaard ◽  
J. O. Jørgensen ◽  
N. Rittig
Keyword(s):  
Diabetes Insipidus ◽  
Antidiuretic Hormone ◽  
Pituitary Apoplexy ◽  
Hormone Secretion ◽  
Central Diabetes Insipidus ◽  
Plasma Sodium ◽  
Fluid Restriction ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Pituitary Dysfunction

Pituitary apoplexy (PA) is a rare endocrine emergency that occasionally presents with sodium disturbances. Here we present a rare case with a previously healthy 41-year-old female who presented with acute onset headache and nausea without visual impairment or overt pituitary dysfunction. Plasma sodium concentrations declined abruptly during the first two days of admission to a nadir of 111 mmol/l. Urine and blood chemistry were consistent with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Magnetic resonance imaging revealed recent bleeding into a pituitary cystic process. Hyponatremia was successfully corrected with fluid restriction and both visual function and anterior pituitary function remained intact. Subsequently, the patient developed central diabetes insipidus (CDI), which responded well to desmopressin substitution. To our knowledge, this is the first case of PA presenting predominantly with posterior pituitary dysfunction that transitioned from SIADH to permanent CDI.

scholarly journals A Case of Pituitary Metastasis of Breast Cancer Presenting as Diabetes Insipidus and Panhypopituitarism

2007 ◽  
Vol 22 (2) ◽  
pp. 125 ◽  
Author(s):  
Jae Wuk Kwak ◽  
Byung Soo Jie ◽  
Sun Hwa Hong ◽  
Ji Hyun Kim ◽  
Seung Hwan Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diabetes Insipidus ◽  
Pituitary Metastasis

scholarly journals Pituitary Metastasis of Lung Neuroendocrine Carcinoma Mimicking Pituitary Adenoma:Case Report and Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaohai Liu ◽  
Renzhi Wang ◽  
Mingchu Li ◽  
Ge Chen
Keyword(s):  
Pituitary Adenoma ◽  
Diabetes Insipidus ◽  
Tumor Resection ◽  
Unknown Primary ◽  
Sellar Region ◽  
Asymptomatic Patients ◽  
Level Of Consciousness ◽  
Multiple Metastases ◽  
Lung Neuroendocrine Tumor ◽  
Pituitary Metastasis

Pituitary metastasis is an unusual situation in clinical practice, while the incidence is increasing with age. Breast cancer for women and lung cancer for men were the most frequent primary origins of pituitary metastasis. Diagnosing asymptomatic patients with unknown primary malignant origin is difficult, thus pituitary metastasis may be diagnosed as primary pituitary adenoma. Here, we report a case of a 65-year-old patient with visual changes and diabetes insipidus, showing an extensive mass in the sellar region which was initially thought to be a primary pituitary adenoma. Patient corticotropic deficits were corrected, and transnasal transsphenoidal surgery was adopted, leading to total tumor resection. Tumor texture during surgical procedure was similar to that of pituitary adenoma. However, the histopathological and immunohistochemistry results suggested it as a pituitary metastasis from lung neuroendocrine tumor. Postoperative chest CT scan confirmed a pulmonary mass consistent with primary neoplasm. Abdominal CT further detected multiple metastases in liver, pancreas, and colon. Despite intensive treatment, the patient continued to show decreased level of consciousness due to cachexia, resulting in death 1 week after surgery. This case highlights the importance of differential diagnosis of invasive lesions of the sellar region, especially in individuals over 60 years of age with diabetes insipidus.

scholarly journals Severe hemoperitoneum resulting from restart of letrozole after oocyte retrieval procedure: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Haipeng Huang ◽  
Yasushi Takai ◽  
Kouki Samejima ◽  
Yosuke Gomi ◽  
Tatsuya Narita ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Oocyte Retrieval ◽  
Recurrent Breast Cancer ◽  
Embryo Cryopreservation ◽  
Case Presentation ◽  
Before And After ◽  
Old Japanese ◽  
Letrozole Treatment ◽  
Recurrent Breast ◽  
Abdominal Hemorrhage

Abstract Background In the field of oncofertility, patients with breast cancer are often administered letrozole as an adjuvant drug before and after oocyte retrieval to prevent an increase in circulating estradiol. Case presentation We report a case of abdominal hemorrhage due to an ovarian rupture in a 29-year-old Japanese patient who restarted letrozole 2 days after an oocyte retrieval procedure in which 14 mature oocytes were retrieved. The patient had sought embryo cryopreservation as a fertility preservation option before undergoing treatment for recurrent breast cancer. A day after restarting letrozole treatment, the patient unexpectedly developed severe abdominal pain. Laparoscopic hemostasis was performed to manage the ovarian swelling and hemorrhage. Conclusions The ovaries can be restimulated by restart letrozole after an oocyte retrieval procedure. Therefore, reproductive-medicine practitioners should understand the potential complications of letrozole administration in such cases and take steps to ensure that they are minimized.

Partial cranial diabetes insipidus in breast cancer: invisible pituitary metastases or uncanny coincidence

2019 ◽  
Author(s):  
Sam Westall ◽  
Heather Sullivan ◽  
Sid McNulty ◽  
Sumudu Bujawansa ◽  
Prakash Narayanan
Keyword(s):  
Breast Cancer ◽  
Diabetes Insipidus ◽  
Pituitary Metastases ◽  
Cranial Diabetes Insipidus

scholarly journals A Case Report of Tongue Lymphoepithelial Carcinoma with a Histological Diagnostic Dilemma

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1039
Author(s):  
Daisuke Takeda ◽  
Manabu Shigeoka ◽  
Tenyu Sugano ◽  
Nanae Yatagai ◽  
Takumi Hasegawa ◽  
...  
Keyword(s):  
Histological Finding ◽  
Atypical Epithelium ◽  
Diagnostic Dilemma ◽  
Barr Virus ◽  
Japanese Female ◽  
Old Japanese ◽  
Neoplastic Change ◽  
Diagnostic Difficulties ◽  
Epstein Barr ◽  
Characteristic Features

Most head and neck lymphoepithelial carcinomas (LECs) arise in the nasopharynx and harbor Epstein–Barr virus (EBV). LEC is also a rare subtype of the oral squamous cell carcinoma (SCC). Morphologically, LEC is defined as resembling non-keratinizing nasopharyngeal carcinoma, undifferentiated subtype. The histological features and pathogenesis of oral LEC are not established. We describe a case of tongue LEC with histopathological diagnostic difficulties. A 72-year-old Japanese female presented with a whitish change on her left-side tongue. The diagnosis was atypical epithelium; neoplastic change could not be ruled out by a biopsy. Although the lesion was monitored at our hospital per her request, invasive carcinoma was detected 11 months later. Microscopically, conventional SCC was observed with the characteristic features as LEC confined to the deep part of the lesion. We briefly discuss this unusual histological finding and make a novel proposal for distinguishing oral LEC from LECs in other regions based on these histological findings.

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