Pituitary metastatic lesion. Features of diagnosis and surgical interventions
Introduction. Pituitary metastases (PM) are a rare pathology requiring immediate differentiation with other processes of the chiasmosellar region.
Objective. To study the features of the clinic and instrumental diagnostics of pituitary metastatic lesion for differential diagnosis with another sellar region tumor and determination of indications for surgical treatment.
Materials and methods. Seventy-three patients with pituitary metastases were retrospectively analyzed. The patients assessed taking into account the clinical picture, using neuroimaging examinations, hormonal examination.
Results. The frequent clinical symptoms in patients with pituitary metastases included diabetes insipidus, oculomotor disorders, visual disturbances and hypopituitarism. The common MRI symptoms for PM were the following: hypophyseal stalk extensive lesions, dumbbell tumor or tumor narrowing in the diaphragmatic aperture, neurohypophysis hypertension loss, increased contrast of the dura mater around the hypophyseal fossa, hypothalamic damage, hyperintensity in the optic tract, intra-tumor hemorrhage. Frequent MSCT- symptom in patients with PM was the destruction of the Turkish saddle walls along with the destruction of adjacent bone formations structure.
Conclusions. Based on the analyzed clinical and diagnostic features, indications for surgical intervention were determined and 35 patients with PM were operated.
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1. Kim YH, Lee BJ, Lee KJ, Cho JH. A case of pituitary metastasis from breast cancer that presented as left visual disturbance. J Korean Neurosurg Soc. 2012 Feb;51(2):94-7. [CrossRef] [PubMed] [PubMed Central]
4. Spinelli GP, Lo Russo G, Miele E, Prinzi N, Tomao F, Antonelli M, Giangaspero F, Stati V, Strudel M, Tomao S. Breast cancer metastatic to the pituitary gland: a case report. World J Surg Oncol. 2012 Jul 9;10:137. [CrossRef] [PubMed] [PubMed Central]
6. Feiz-Erfan I, Rao G, White WL, McCutcheon IE. Efficacy of Trans-septal Trans-sphenoidal Surgery in Correcting Visual Symptoms Caused by Hematogenous Metastases to the Sella and Pituitary Gland. Skull Base. 2008 Mar;18(2):77-84. [CrossRef] [PubMed] [PubMed Central]
8. Ito I, Ishida T, Hashimoto T, Arita M, Osawa M, Yokota T, Ishimori T. Hypopituitarism due to pituitary metastasis of lung cancer: case of a 21-year-old man. Intern Med. 2001 May;40(5):414-7. [CrossRef] [PubMed]
10. He W, Chen F, Dalm B, Kirby PA, Greenlee JD. Metastatic involvement of the pituitary gland: a systematic review with pooled individual patient data analysis. Pituitary. 2015 Feb;18(1):159-68. [CrossRef] [PubMed]
13. Gilard V, Alexandru C, Proust F, Derrey S, Hannequin P, Langlois O. Pituitary metastasis: is there still a place for neurosurgical treatment? J Neurooncol. 2016 Jan;126(2):219-24. [CrossRef] [PubMed]
16. Komninos J, Vlassopoulou V, Protopapa D, Korfias S, Kontogeorgos G, Sakas DE, Thalassinos NC. Tumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab. 2004 Feb;89(2):574-80. [CrossRef] [PubMed]
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Copyright (c) 2018 Mykola O. Guk, Dmytro S. Teslenko, Arthur O. Mumliev, Viktor A. Yatsyk, Dmytro I. Okonskyi, Ruslan V. Aksyonov, Dmytro V. Kubryak
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