DOI: https://doi.org/10.25305/unj.98083

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

Abstract


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.


Keywords


pituitary; metastases; clinical picture; diagnostics; surgical treatment

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