Pituitary metastasis from breast cancer

Case contributed by Galina Kalchenko

Presentation

The patient was treated in the hospital for multifocal cancer of the lower outer quadrant of the left breast. The patient asked the ophthalmologist about complaints of lacrimation and the loss of sight from the right temporal side.

Patient Data

Age: 55 years
Gender: Female

ASNR 2016
This case was submitted as part of the American Society of Neuroradiology (ASNR 2016) Case of the Day competition, in collaboration with Radiopaedia.org. 

MRI Brain

MRI

Lobulated sellar-suprasellar mass measuring 29 x 27 x 21 mm, expanding the sella turcica and enhancing intensely and unevenly. The mass appears to involve the optic chiasm, which is deformed and increased in volume, and extends to the bottom of the third ventricle and along the planum sphenoidale. There are symmetric swelling and reactive changes along the optic tracts without pathological contrast enhancement. The mass is adjacent to both internal carotid arteries but does not involve them.

Case Discussion

The case demonstrates an uncommon example of a hypophyseal metastasis from breast cancer, which should be differentiated from other solid and enhancing pituitary region masses, such as macroadenoma. The patient was operated on. Biopsy revealed metastasis of breast cancer in the pituitary gland.

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