Endocrine Abstracts

Pituitary tumor is a rare endocrine disorder. In the majority of cases, they are secreting prolactin and/or GH. Pituitary metastatic tumors are localized more often in the nervous than adenomatous hypophysis. Lung, breast and large intestine cancers metastases are found in the pituitary in the most cases. They cause hypopituitarism and local complications. The most often complications found are an optic nerve chiasm pressure or infiltration with a visual field loss, cavernous sinus infiltration, bone destruction, pressure and infiltration of the local brain regions, increased intracranial pressure. Headaches and ophthalmoplegy are often not connected to hypopituitarism, but an aggressive neoplasm.

We reported 67-year-old man referred from General Practitioner to hospital admission due to vertigo, syncope, visual loss and pituitary tumor revealed in the CT scans. The tumor infiltrated bones, soft tissues, the optic nerve chiasm also and caused progressive visual field loss. The patient had prostate cancer diagnosed and treated some years before. Secondary hypothyroidism, adrenal insufficiency and hypogonadotropic hypogonadism were shown. An X-ray chest scan revealed not significant right pulmonary recess enlargement. The right pulmonary recess diagnosing was postponed, due to fast progressive patient’s bilateral visual loss. Suitable replacement therapy was prescribed. The man was referred to an urgent neurosurgery. Tumor histopathological examination revealed small-cell cancer. Then patient was referred to Pulmonary Clinic, where small-cell lung cancer with pituitary and liver metastases was diagnosed. There was no response to palliative chemotherapy, patient died due to lung cancer progression.

Pituitary metastatic tumors, although rare in general, often appeared in metastatic cancers. The presence of an invasive pituitary tumor should indicate a need to looking for a malignant lesion.