Metastatic Pituitary Disorders

Česká verzia

Authors: V. Novák ¹; L. Hrabálek ¹; M. Hampl ¹; J. Hoza ²; Z. Fryšák ³; M. Vaverka ¹
Authors place of work: Neurochirurgická klinika LF UP a FN Olomouc ¹; Otolaryngologická klinika LF UP a FN Olomouc ²; III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP a FN Olomouc ³
Published in the journal: Klin Onkol 2017; 30(4): 273-281
Category: Přehled
doi: https://doi.org/10.14735/amko2017273

Summary

Background:
Pituitary metastases are a rare complication of generalized cancer. Metastases to the pituitary gland occur in only 1% of patients operated on for sellar tumor. The most common presenting symptom in patients with pituitary metastases is diabetes insipidus, whereas this is rare in those with pituitary adenoma.

Material and Methods:
This publication presents the cases of two patients with pituitary metastases and a systematic review of the literature. English-language publications related to pituitary metastases and published from 1957 to 2016 were identified using the PubMed database.

Results:
A total of 131 publications containing information about 259 patients (121 female and 138 male; mean age, 57.3 years) were identified. The most often metastasized breast carcinoma (24.6%) and lung carcinoma (23.8%), followed by thyroid carcinoma (11.3%), renal cell carcinoma (7.8%), hepatocellular carcinoma (4.3%), colorectal carcinoma (3.5%), and malignant melanoma (3.5%). The most frequent initial symptoms were manifestations of diabetes insipidus (39.6%), anterior pituitary deficiency (44.9%), perimeter disorders (51.6%), headache (37.6%), cranial nerve palsy (33.5%), and pseudoprolactinemia (16.7%). Radiotherapy (67.8%) and surgical treatment (63.9%) were the most frequently used treatment.

Conclusion:
The average survival time from the onset of metastatic disease was 11.8 months. Surgical therapy alone or in combination with radiation therapy does not prolong survival, but alleviates symptoms and improves quality of life.

Key words:
pituitary metastasis – diabetes insipidus – hypopituitarism – transsphenoidal surgery

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
13. 1. 2017

Accepted:
4. 4. 2017

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