Pituitary metastasis - from breast cancer

Case contributed by Dr Lukas Valkovic

Presentation

Sudden vision loss in one eye. History of breast cancer.

Patient Data

Age: 60 years
Gender: Female

There is a lobulated mass in the sellar and suprasellar region with encapsulation of the optic chiasm and nerves. It has direct contact with the anterior cerebral arteries bilaterally. 

There are also another two mild enhancing lesions between vermis and right cerebellar peduncle and at the anterior edge of the left cerebellar hemisphere. 

Case Discussion

Normally we would suggest a primary tumor of hypophysis (macroadenoma or craniopharyngioma), but the sudden onset of vision loss and presence of other lesions in the cerebellar region with a history of breast cancer were strongly suggestive of metastases. Breast cancer is known to metastasize into the brain, with intraparenchymal and also dural spread. 

In the next 3 months, the patient underwent chemotherapy and whole brain radiotherapy with almost complete resolution of the lesions.

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