![](/images/graphics-bg.png)
Symptomatic Pituitary Metastasis as Initial Manifestation of Renal Cell Carcinoma: Case Report and Review of Literature
المؤلفون المشاركون
Gandhi, Gunjan Y.
Fung, Russell
Natter, Patrick E.
Balaji, K. C.
Makary, Raafat
المصدر
العدد
المجلد 2020، العدد 2020 (31 ديسمبر/كانون الأول 2020)، ص ص. 1-10، 10ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2020-08-18
دولة النشر
مصر
عدد الصفحات
10
التخصصات الرئيسية
الملخص EN
Metastasis to the pituitary gland is extremely rare (∼2% of sellar masses).
Clinical, biochemical, and radiologic characteristics of pituitary metastasis are poorly defined and can be difficult to diagnose before surgery.
We present an unusual case with pituitary metastasis as the first manifestation of renal cell carcinoma (RCC).
A 70-year-old male presented with acute onset of weakness, dizziness, diplopia, and progressively worsening headache.
The initial CT head revealed a heterogeneous sellar mass measuring 2.8 × 1.9 × 1.7 cm.
A follow-up MRI showed the sellar mass invading the right cavernous sinus.
The presumptive diagnosis was a pituitary macroadenoma.
Physical examination revealed bilateral 6th cranial nerve palsy and episodes of intermittent binocular horizontal diplopia.
Hormonal testing noted possible secondary adrenal insufficiency (AM serum cortisol: 3.3 mcg/dL, ACTH: 8 pg/mL), secondary hypothyroidism (TSH: <0.01 mIU/L, FT4: 0.7 ng/dL), secondary hypogonadism (testosterone: 47 ng/dL, LH: 1.3 mIU/mL, and FSH: 2.3 mIU/mL), and elevated serum prolactin (prolactin: 56.8 ng/ml, normal: 4.0–15.2 ng/ml).
IGF-1 level was normal at 110 ng/mL (47–192 ng/mL).
The patient was discharged on levothyroxine and hydrocortisone therapy with plans for close surveillance.
However, his condition worsened over the next three months, and he was subsequently readmitted with nausea, vomiting, and hypernatremia secondary to diabetes insipidus.
Repeat MRI pituitary showed an interval increase in the size of the sellar mass with suprasellar extension and a new mass effect on the optic chiasm.
The sellar mass was urgently resected via a trans-sphenoidal approach.
The tumor was negative for neuroendocrine markers and pituitary hormone panel, ruling out the diagnosis of pituitary adenoma and triggered workup for metastatic renal cell carcinoma, clear cell type.
The diagnosis of renal cell carcinoma was confirmed by the diffuse and strong staining for renal cell carcinoma markers (Pax-8, RCC-1, and CD10).
A follow-up CT scan noted large right renal mass measuring 11 × 10 × 11 cm.
The patient underwent a cytoreductive robotic right radical nephrectomy for WHO/ISUP histologic grade II clear cell RCC, stage pT2b pNX pM1.
He subsequently received fractionated stereotactic radiotherapy to the pituitary gland.
He is presently stable with no radiological evidence of progression or new intracranial disease on subsequent imaging.
Pituitary metastasis most commonly occurs from breast, lung, or gastrointestinal tumors but also rarely from renal cell carcinoma.
Biochemical findings such as panhypopituitarism, acute clinical signs such as headache, visual symptoms, and diabetes insipidus and interval increase in sellar mass in a short time interval should raise suspicion for sellar metastasis.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Gandhi, Gunjan Y.& Fung, Russell& Natter, Patrick E.& Makary, Raafat& Balaji, K. C.. 2020. Symptomatic Pituitary Metastasis as Initial Manifestation of Renal Cell Carcinoma: Case Report and Review of Literature. Case Reports in Endocrinology،Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1147141
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Gandhi, Gunjan Y.…[et al.]. Symptomatic Pituitary Metastasis as Initial Manifestation of Renal Cell Carcinoma: Case Report and Review of Literature. Case Reports in Endocrinology No. 2020 (2020), pp.1-10.
https://search.emarefa.net/detail/BIM-1147141
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Gandhi, Gunjan Y.& Fung, Russell& Natter, Patrick E.& Makary, Raafat& Balaji, K. C.. Symptomatic Pituitary Metastasis as Initial Manifestation of Renal Cell Carcinoma: Case Report and Review of Literature. Case Reports in Endocrinology. 2020. Vol. 2020, no. 2020, pp.1-10.
https://search.emarefa.net/detail/BIM-1147141
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1147141
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
![](/images/ebook-kashef.png)
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر
![](/images/kashef-image.png)