Pituitary metastases: 3 cases

OBJECTIVE: Review cases with hyothalamo-hypophyseal metastases which raise complex therapeutic situations. PATIENTS AND METHODS: Files of patients hospitalized from 1992 to 1996 at t he Cochin Hospital Endocrinology unit were compared with data reported in t he literature. RESULTS: We had patients with pituitary metastases from breast cancer and 6 9 cases have been reported in the literature. 72 patients, 57% men and 43% women, mean age 57.2 +/- 12.3 years. The primary tumor was identified in 58 .3% of the cases. The primary cancer was unknown and revealed by the pituit ary metastasis in 41.7% of the cases. The primary tumor was a breast cane e r in 31.9% of the cases, and lung cancer in 30.5%. The main clinical signs were vision disorders (40.3%) and diabetes insipisus (29.1%). The principal differential diagnosis was hypophyseal adenoma. Short term prognosis was n ot good. DISCUSSION: These data are in agreement with the older literature excepting the high prevalence of primary cancers revealed by pituitary metastasis, p robably a result of progress in hypophyseal exploration techniques. CONCLUSION: The prevalence of pituitary metastasis will continue to increas e with longer survival in cancer patients. Metastasis should thus be entert ained as a possibility in patients with a hypothalamo-hypophyseal tumor, pa rticularly after the age of 59, in order to hasten diagnosis and provide ea rly treatment.