Panhypopituitarism secondary to hypophyseal metastasis

BACKGROUND: Hypophyseal metastatic localizations are uncommon and rarely th e first expression of a primary cancer. We report an exceptional case revea led by panhypopituitarism and diabetes insipidis. CASE REPORT: Brain MRI visualized an intra- and suprasellar tumoral formati on found to be a cribiform adenocarcinoma. The primary tumor could not be i dentified. Despite radiotherapy, surgery and chemotherapy combining carbopl atin and etoposide, the tumor progressed with the development of cervical a nd mediastinal nodes. The patient died one year after onset of the clinical signs. DISCUSSION: Diagnosis of hypophyseal metastasis is mainly based on indirect evidence: rapid course, invasion of neighboring structures. Optimal manage ment of these rare tumors remains to be determined.