ECE2019 Poster Presentations Adrenal and Neuroendocrine Tumours 3 (70 abstracts)
Pituitary metastasis of Neuroendocrine Carcinoma – a rare case report
Raquel Castro 1 , Daniel Macedo 2 , Domingos Coiteiro 2 , Pedro Vilela 2 , Manuela Mafra 2 , Cristina Pinto 2 , Cristina Loewenthal 2 , Monica Nave 2 & Francisco Rosário 2
1Hospital de Santa Maria, Lisboa, Portugal; 2Hospital da Luz, Lisboa, Portugal.
The authors report the clinical case of a 59-year old female who had vague complaints of impaired vision, fatigue and diffuse pain for more than a year before medical evaluation at our hospital. At the ophthalmology appointment, bitemporal hemianopsia was evident. Brain MRI was the diagnostic test of choice and revealed a mass involving de sellar and suprassellar space, causing compression of the optic chiasm, as well as osteolytic lesions in cranial vault. The patient was then referred to the endocrinology department where hypopituitarism was detected in blood work-up; hormone replacement therapy ensued. Whole-body CT screening identified pulmonary, pancreatic and hepatic nodules and multiple bone metastasis on axial skeleton were evident on skeletal scintigraphy. Surgical removal of the suprassellar mass and a bone biopsy of the cranial osteolytic lesions were scheduled, and histological findings confirmed both lesions as metastasis of a neuroendocrine carcinoma with a Ki 67 between 5 and 10%. Visual impairment improved after surgery, but de novopolyuria and polydipsia required therapy with desmopressin. Octreotide scan showed increased tracer uptake in the sella turcica, thorax, liver and right iliac fossa. The patient started monthly injections of long-acting octreotide, but follow-up scintigraphy revealed progression of pulmonary and bone lesions six months after surgery, with concurrent deterioration of the patient performance status and increased pain complaints. Further follow-up studies were performed at the patient’s local hospital. This clinical setting is particularly rare since most pituitary metastases are clinically silent. Moreover, the rarity of a pituitary metastasis of a neuroendocrine carcinoma is also to be noted. Guarded prognosis of such malignant disease was evident, considering therapeutic resistance, even though it is typically a slow-growing tumor.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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