PITUITARY METASTASIS MIMICKING A PITUITARY-ADENOMA - A DESCRIPTION OF2 CASES

The cases of two elderly women treated for temporal hemianopsia due to a large pituitary mass with suprasellar extension are presented. In b oth cases, the clinical picture, without diabetes insipidus and crania l nerve paralysis, as well the neuroimaging and endocrinological inves tigation showing hypopituitarism, were suggestive of a non-secreting p ituitary adenoma. In the first patient malignant tissue was unexpected ly encountered during transsphenoidal surgery. Anatomopathological inv estigation confirmed the presence of a metastasis of a breast carcinom a for which she had been treated 17 years earlier. In the second patie nt, a preoperative chest X-ray before transsphenoidal surgery revealed an asymptomatic bronchial tumour. Subsequently a squamous cell carcin oma with a metastasis in the pituitary was confirmed. These two cases illustrate the fact that a pituitary metastasis can closely mimic a pi tuitary adenoma. Even in the absence of suggestive symptoms such as di abetes insipidus and/or cranial nerve paralysis the possibility of met astatic disease in the differential diagnosis of a pituitary mass shou ld always be considered.