scholarly journals Metastases to the pituitary gland

2004 ◽  
Vol 16 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Daniel R. Fassett ◽  
William T. Couldwell
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Skull Base ◽  
Survival Rates ◽  
Tumor Resection ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Visual Field Defects ◽  
Malignant Neoplasms ◽  
Pituitary Metastases

Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

scholarly journals Pituitary metastases as a rare variant of intracranial metastasis

2008 ◽  
Vol 7 (5-2) ◽  
pp. 332-337
Author(s):  
A. V. Osnitskaya ◽  
V. Ye. Olyushin
Keyword(s):  
Pituitary Gland ◽  
Tumor Resection ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Common Finding ◽  
Visual Field Defects ◽  
Primary Malignancy ◽  
Intracranial Metastasis ◽  
Lung Cancers ◽  
Pituitary Dysfunction

Metastatiс spread of neoplasms to the pituitary gland is a relatively common finding in autopsy series of cancer patients. The majority of these patients were asymptomatic. Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland. From 1993 through 2008, 3 patients with symptoms arising from tumor metastasis to the pituitary gland were evaluated at the Russian Polenov Neurosurgical Institute.Breast and lung cancers are the most common diseases that metastasize to the pituitary.In two patients, the primary malignancy was breast. In one case, the primary tumor was lung. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia were the most commonly reported symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved.

The Nasal Gateway for Pituitary Surgery

1988 ◽  
Vol 2 (4) ◽  
pp. 193-200 ◽  
Author(s):  
Mary D. Lekas
Keyword(s):  
Pituitary Gland ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Pituitary Surgery ◽  
Transsphenoidal Approach ◽  
External Rhinoplasty

There has been an evolution in the transseptal transsphenoidal approach for pituitary surgery. The nasal approach to the pituitary gland can be from the sublabial transseptal transsphenoidal; the transseptal transsphenoidal; the alotomy transseptal transsphenoidal; the external rhinoplasty transsphenoidal; the transnasal by mobilizing the whole nose on a pedicle; the transseptal infranasal; the midline columellar incision; all types of nasofacial incisions; and transethmoidal approach with nasal instrumentation. The transsphenoidal hypophysectomy surgery has become a safe and effective approach for pituitary tumors. We are mainly concerned with the transnasal and not the transethmoidal approach to the sella turcica at this time.

Diseases of the Pituitary Gland

2018 ◽  
pp. 373-394
Author(s):  
Vânia Nosé ◽  
Sandro Santagata ◽  
Edward R. Laws
Keyword(s):  
Cell Differentiation ◽  
Infectious Diseases ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Sella Turcica ◽  
Vascular Lesions ◽  
Malignant Neoplasms ◽  
Systemic Diseases ◽  
Pathological Findings ◽  
Hormone Production

Diseases of the pituitary gland are common, and the most frequently encountered lesions within the sella turcica and pituitary are described and illustrated in details in this chapter. The lesions present within this chapter include cysts and malformations, vascular lesions, inflammatory disorders, infectious diseases, systemic diseases, and both benign and malignant neoplasms. The most common neoplasms of the pituitary are the pituitary adenomas, and these are described in detail including the numerous subtypes depending on the cell differentiation and hormone production. The chapter contains numerous tables and figures illustrating the pathological findings.

scholarly journals Lateral skull base malignancies

2002 ◽  
Vol 12 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Benjamin M. McGrew ◽  
C. Gary Jackson ◽  
Raquel A. Redtfeldt
Keyword(s):  
Skull Base ◽  
Postoperative Radiotherapy ◽  
Survival Rates ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Lateral Skull Base ◽  
The Mean ◽  
Poor Outcomes

Object Historically poor outcomes have been characteristic in patients with lateral skull base malignancies. As advances in skull base surgical techniques have been made, complete resection has increasingly been achieved. This has resulted in improved survival rates and local tumor control. Methods The authors performed a retrospective review of 95 patients treated for lateral skull base malignancies. The mean age of the patients was 49.4 years. There were 44 females and 51 males. The mean follow-up period was 50 months. Resection was performed in all patients, and postoperative radiotherapy was undertaken in 54% of the cases. Local disease control was maintained in 73% of the patients. Tumor involvement of the facial nerve and intracranial tumor extension did not jeopardize the rate of local control. Conclusions Despite the fact that technical advances in skull base surgery have resulted in a higher incidence of complete tumor resection and improved survival rates, a respect for the poor prognosis historically associated with lateral skull base malignancies should be maintained and treatment should be appropriately aggressive.

Intraoperative Vagal Nerve Monitoring

1996 ◽  
Vol 75 (8) ◽  
pp. 489-496 ◽  
Author(s):  
John P. Leonetti ◽  
W. Scott Jellish ◽  
Patricia Warf ◽  
Elizabeth Hudson
Keyword(s):  
Skull Base ◽  
Vocal Cord ◽  
Infratemporal Fossa ◽  
Tumor Resection ◽  
Vagal Nerve ◽  
Malignant Neoplasms ◽  
Nerve Monitoring ◽  
Lateral Skull Base ◽  
Vagal Nerves ◽  
Functional Preservation

A variety of benign and malignant neoplasms occur in the superior cervical neck, parapharyngeal space or the infratemporal fossa. The surgical resection of these lesions may result in postoperative iatrogenic injury to the vagus nerve with associated dysfunctional swallowing and airway protection. Anatomic and functional preservation of this critical cranial nerve will contribute to a favorable surgical outcome. Fourteen patients with tumors of the cervical neck or adjacent skull base underwent intraoperative vagal nerve monitoring in an attempt to preserve neural integrity following tumor removal. Of the 11 patients with anatomically preserved vagal nerves in this group, seven patients had normal vocal cord mobility following surgery and all 11 patients demonstrated normal vocal cord movement by six months. In an earlier series of 23 patients with tumors in the same region who underwent tumor resection without vagal nerve monitoring, 18 patients had anatomically preserved vagal nerves. Within this group, five patients had normal vocal cord movement at one month and 13 patients demonstrated normal vocal cord movement at six months. This paper will outline a technique for intraoperative vagal nerve monitoring utilizing transcricothyroid membrane placement of bipolar hook-wire electrodes in the vocalis muscle. Our results with the surgical treatment of cervical neck and lateral skull base tumors for patients with unmonitored and monitored vagal nerves will be outlined.

scholarly journals ХАРАКТЕРИСТИКА НАРУШЕНИЙ РАЗВИТИЯ ПРИ ОБЪЕМНЫХ ЗАБОЛЕВАНИЯХ ГИПОФИЗА У ДЕТЕЙ И ПОДРОСТКОВ

Innova ◽  
2019 ◽  
Vol 15 ◽  
pp. 31-34
Author(s):  
Урманова Ю.М. ◽  
◽  
Мавлонов У.Х. ◽  
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Children And Adolescents ◽  
Cushing’S Disease ◽  
Pituitary Adenomas ◽  
Developmental Disorders ◽  
Pituitary Tumors ◽  
Cushing's Disease

The aim of the study was to study the nature of developmental disorders in children and adolescents with masses of the Turkish saddle. Material and methods. 44 children and adolescents with large tumors of the Turkish saddle (TS) were under our supervision in the neuroendocrinology department of the RSNPMCE MH RUz. Of 44 sick girls there were 20, boys 24. The average age of girls was 12.1 years, boys - 12.8 years. By the nature of the pathology, the patients were divided into 5 groups: I group. - inactive pituitary adenomas (NAG) - 23 patients (52.3%); II gr. - Itsenko-Cushing's disease - 5 (11.4%); III gr. - craniopharyngioma - 6 (13.6%); IV gr. - prolactinoma - 5 b-x (11.4%); V gr. - germinoma - 5 bx (11.4%). Results. The results obtained indicate that in children and adolescents there are TJ masses of various origins: inactive pituitary adenomas (52%), craniopharyngiomas (13.6%), corticotropinomas (11.4%), prolactinomas (11.4%), and others. The presence of diabetes insipidus (8.6%) indicates the severity of panhypopituitarism that developed as a result of the tumor. Conclusions: 1) disorders of growth and puberty are the most frequent manifestations of pituitary gland masses (34.0%), 2) pituitary tumors in children and adolescents often lead to hypo- and panhypopituitarism (n = 19, or 43.2%).

Clival chordomas: clinical management, results, and complications in 71 patients

2010 ◽  
Vol 113 (5) ◽  
pp. 1059-1071 ◽  
Author(s):  
Chandranath Sen ◽  
Aymara I. Triana ◽  
Niklas Berglind ◽  
James Godbold ◽  
Raj K. Shrivastava
Keyword(s):  
Skull Base ◽  
Proton Beam ◽  
Positive Impact ◽  
Tumor Resection ◽  
Radical Resection ◽  
Surgical Approaches ◽  
Malignant Neoplasms ◽  
Radical Excision ◽  
Number Of Patients ◽  
Csf Leakage

Object Chordomas are rare malignant neoplasms arising predominantly at the sacrum and skull base. They are uniformly lethal unless treated with aggressive resection and proton beam irradiation. The authors present results of the surgical management of a large number of patients with clivus chordomas. Factors that influence the surgeon's ability to achieve radical tumor resection are also evaluated. Methods Between 1991 and 2005, 71 patients with clivus chordomas underwent surgery. The average follow-up was 66 months (median 60 months, range 3–189 months). Sixty-five patients had complete records that were analyzed in the present report. Thirty-five percent of them had undergone surgery before being treated by the authors. They were evaluated with MR imaging and CT scanning and underwent surgery utilizing a variety of skull base techniques aimed at achieving radical excision. Many also underwent postoperative radiation, usually in the form of proton beam therapy. The patients were followed up with serial imaging at regular intervals as well as with neurological evaluation. Results Radical tumor resection was achieved in 58% of the group. The overall 5-year survival rate was 75%. Radical resection had a positive impact on survival. The ability to achieve radical resection was dependent on the preoperative tumor volume and the number of anatomical areas involved by the tumor. Cranial nerve impairment and CSF leakage were the most frequent postoperative complications. Conclusions Radical excision is the ideal surgical goal in the treatment of clival chordomas and can be achieved with reasonable risks. Several different surgical approaches may be necessary to accomplish this.

scholarly journals A case of central diabetes insipidus associated with a congenital cyst of the sella turcica in a young cat

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692093501
Author(s):  
Cyril Duperrier ◽  
Marion Fusellier ◽  
Hendrik Lenaerts ◽  
Amandine Drut ◽  
Juan Hernandez
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Brain Mri ◽  
Previous History ◽  
Sella Turcica ◽  
Plasma Osmolality ◽  
Central Diabetes Insipidus ◽  
Cns Lymphoma ◽  
First Case ◽  
Pituitary Cyst

Case summary A 1-year-old neutered male domestic shorthair cat was presented for polyuria and polydipsia which had progressed since adoption, 7 months previously. On admission, clinical examination did not reveal any remarkable features. Urinalysis showed marked hyposthenuria and calculated plasma osmolality was high, suggesting diabetes insipidus. A positive response to desmopressin administration appeared to confirm pituitary dysfunction. Brain MRI revealed a lesion compatible with a cyst or a neoplasm compressing the pituitary gland. A follow-up MRI performed 9 months later showed that the lesion was stable, which at first argued in favour of a congenital pituitary cyst. Intranasal administration of desmopressin was then used to achieve a long-term clinical response. Relevance and novel information Central diabetes insipidus (CDI) is a rare cause of polyuria and polydipsia in cats, resulting from inadequate or impaired secretion of antidiuretic hormone from the posterior pituitary gland. Recognised causes include head trauma, central nervous system (CNS) neoplasia, idiopathic CDI and congenital pituitary cysts. Apart from one cat with CNS lymphoma, the few previously reported feline cases have described CDI in young cats with a previous history of trauma, but brain imaging has rarely been performed to look for underlying anatomical abnormalities. This report describes the first case of CDI in a cat with a confirmed congenital pituitary cyst and, as in previous cases, demonstrates successful treatment with desmopressin.

Diabetes insipidus due to pituitary metastasis in a woman with lung adenocarcinoma: a case report

Open Medicine ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. 475-479
Author(s):  
Chen-Hao Hsiao ◽  
Chung-Yih Wang ◽  
Ming-Teng Chung ◽  
Ming-Sung Yang
Keyword(s):  
Lung Adenocarcinoma ◽  
Diabetes Insipidus ◽  
Brain Magnetic Resonance Imaging ◽  
Pituitary Tumors ◽  
Common Symptom ◽  
Pituitary Mass ◽  
Primary Tumors ◽  
Lung Cancers ◽  
Medical Issues ◽  
Pituitary Metastases

AbstractMetastatic tumors of the pituitary are uncommon and usually asymptomatic. They are often incidental findings from imaging workups for other medical issues or from the assessment of primary tumors in other locations. Diabetes insipidus is the most common symptom resulting from pituitary tumors, including pituitary metastases. A 56-year-old woman with primary lung adenocarcinoma underwent video-assisted thoracic bilobectomy. Regular follow-up was unremarkable until 15 months after surgery, when she presented with polyuria and polydipsia suggestive of diabetes insipidus. A pituitary mass was found on brain magnetic resonance imaging; the diagnosis of lung adenocarcinoma metastasized to the pituitary was confirmed by trans-sphenoidal surgery and biopsy of the pituitary mass. Diabetes insipidus and hormonal profiles are the key to recognize the existence of pituitary metastases, and patients with primary lung cancers presenting with diabetes insipidus should be evaluated for pituitary metastases.

scholarly journals Metastatic Mantle Cell Lymphoma to the Pituitary Gland: Case Report and Literature Review

2016 ◽  
Vol 9 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Arthur Wang ◽  
Nathan Carberry ◽  
Elena Solli ◽  
George Kleinman ◽  
Adesh Tandon
Keyword(s):  
Pituitary Gland ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Surgical Excision ◽  
Gastrointestinal Carcinoma ◽  
Metastatic Lesions ◽  
Mantle Cell ◽  
History Of

We present an unusual case of a metastatic mantle cell lymphoma (MCL) to the pituitary gland. The patient had a known history of MCL for which she previously received chemotherapy. She presented with new-onset diplopia and confusion, and reported a history of progressive vision blurriness associated with headache, nausea, and vomiting. MRI of the brain showed an enhancing lesion within the sella turcica involving the cavernous sinuses bilaterally, extending into Meckel's cave on the left, and abutting the optic nerves bilaterally. Following surgical excision, histopathology revealed the tumor to be a MCL. Metastatic pituitary tumors are rare and have been estimated to make up 1% of tumors discovered in the sellar region. The two most common secondary metastatic lesions to the sella are breast and lung carcinoma followed by prostate, renal cell, and gastrointestinal carcinoma. Metastatic lymphoma to the pituitary gland is especially rare and is estimated to constitute 0.5% of all metastatic tumors to the sella turcica. To our knowledge, this is the first reported case of MCL metastasizing to the pituitary gland.

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