Pituitary metastatic lesion. Features of diagnosis and surgical interventions

Mykola O. Guk, Dmytro S. Teslenko, Arthur O. Mumliev, Viktor A. Yatsyk, Dmytro I. Okonskyi, Ruslan V. Aksyonov, Dmytro V. Kubryak


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.


pituitary; metastases; clinical picture; diagnostics; surgical treatment


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]

2. Altay T, Krisht KM, Couldwell WT. Sellar and parasellar metastatic tumors. Int J Surg Oncol. 2012;2012:647256. [CrossRef] [PubMed] [PubMed Central]

3. Branch CL Jr, Laws ER Jr. Metastatic tumors of the sella turcica masquerading as primary pituitary tumors. J Clin Endocrinol Metab. 1987 Sep;65(3):469-74. [CrossRef] [PubMed]

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]

5. Chiang MF, Brock M, Patt S. Pituitary metastases. Neurochirurgia (Stuttg). 1990 Jul;33(4):127-31. [CrossRef] [PubMed]

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]

7. Fassett DR, Couldwell WT. Metastases to the pituitary gland. Neurosurg Focus. 2004 Apr 15;16(4):E8. [CrossRef] [PubMed]

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]

9. Eksi MS, Hasanov T, Yilmaz B, Akakin A, Bayri Y, Bozkurt SU, Kilic T. Isolated metastasis of breast cancer to the pituitary gland. Neurol India. 2014 Jan-Feb;62(1):70-1. [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]

11. Morita A, Meyer FB, Laws ER Jr. Symptomatic pituitary metastases. J Neurosurg. 1998 Jul;89(1):69-73. [CrossRef] [PubMed]

12. Zoli M, Mazzatenta D, Faustini-Fustini M, Pasquini E, Frank G. Pituitary metastases: role of surgery. World Neurosurg. 2013 Feb;79(2):327-30. [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]

14. Burkhardt T, Henze M, Kluth LA, Westphal M, Schmidt NO, Flitsch J. Surgical management of pituitary metastases. Pituitary. 2016 Feb;19(1):11-8. [CrossRef] [PubMed]

15. Teears RJ, Silverman EM. Clinicopathologic review of 88 cases of carcinoma metastatic to the putuitary gland. Cancer. 1975 Jul;36(1):216-20. [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]

GOST Style Citations

Copyright (c) 2018 Mykola O. Guk, Dmytro S. Teslenko, Arthur O. Mumliev, Viktor A. Yatsyk, Dmytro I. Okonskyi, Ruslan V. Aksyonov, Dmytro V. Kubryak

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.