Metastases to pituitary gland

Case contributed by Dr Lillian Lai

Presentation

Six month history of polyuria and polydypsia with two episodes of dehydration induced syncope. Further endocrinology work-up showed panhypopituitarism including secondary hypogonadism, hypothyroidism, adrenal insufficiency, and central diabetes insipidus.

Patient Data

Age: 58
Gender: Male
Modality: CT

CT shows a sellar/suprasellar hyperattenuating mass.

MRI

Modality: MRI

MRI demonstrates an enhancing, diffusion restricting bilobed pituitary mass with extension into the suprasellar compartment. Compression of the optic chiasm by the suprasellar component with increased FLAIR signal in the bilateral optic nerves and bilateral optic tracts.

Modality: CT

Cavitary right upper lobe 18 mm nodule with mediastinal and hilar adenopathy concerning for primary lung cancer with lymph node metastasis.

Case Discussion

Pathology from resection of the sellar/suprasellar mass revealed metastatic poorly differentiated carcinoma (+P63 raises possibility of squamous cell carcinoma) with primary lung cancer. Residual brain parenchyma showed an abrupt transition between the tumor cells and the brain parenchyma.

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Case Information

rID: 30598
Case created: 20th Aug 2014
Last edited: 17th Sep 2015
Inclusion in quiz mode: Included

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