PITUITARY-GLAND METASTASES

Background: Symptomatic pituitary metastasis is an uncommon clinical p roblem. It may be difficult to distinguish pituitary metastasis from p ituitary adenomas both clinically and radiographically. We present our experience with these tumors and compare it with the findings in the literature. Method: Eight cases are reported here. The medical records were reviewed concerning clinical features, radiographic findings, tr eatment, and outcome. Results: Diabetes insipidus is associated with e ach case and was the initial manifestation of systemic malignancy in t wo of our patients, Half of the patients had headaches as well, Panhyp opituitarism and visual field defects were noted in 25% of the patient s. In 50% of the patients metastasis was limited to the pituitary glan d only. All patients received radiation treatment and exogenous vasopr essin. Two patients underwent resection of the tumor, Five patients di ed within a few months of diagnosis of pituitary metastasis. One patie nt died 2 years after the diagnosis and two patients were lost to foll ow-up. Conclusions: When a patient with known metastatic cancer develo ps diabetes insipidus and has radiographic evidence of a pituitary mas s, the diagnosis of metastasis is highly probable. Reasonable treatmen t is palliative with exogenous vasopressin and radiotherapy.