Presentation
Repeated attacks of vomiting in a known case of lung cancer
Patient Data
Multiple bilateral focal lesions are seen displaying a predominant intermediate signal on T2, T1 and FLAIR. Some of these lesions are associated with vasogenic edema eliciting a high signal on T2 and FLAIR while eliciting a low signal on T1. No associated diffusion restriction.
Following contrast administration, innumerable enhancing lesions are seen scattered on both cerebral hemispheres mainly located at the grey-whit matter junction. Pituitary stalk, multiple cerebellar and dural metastases are also seen.
Case Discussion
Pituitary metastases are rare, usually involving the posterior gland and associated with poor outcome. The most frequent primary tumors are breast and lung cancers. Clinical presentations can be variable and patients usually present with visual field defects or pituitary hormonal dysfunction. Treatment options may include radiotherapy, chemotherapy or surgical resection for symptoms relief.
Case courtesy: Prof. Dr. Yasser Ragab