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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pituitary regulates the body's endocrine system, including the thyroid gland, adrenal cortex, ovaries and testes, through the release of numerous hormones. Pituitary function, in turn, is regulated through complex feedback loops involving the hypothalamus and the target endocrine glands. Hypopituitarism may result from multiple causes, including primary and metastatic cancer, ischemic and granulomatous disease, infection, developmental abnormalities and trauma, which may affect the gland itself (primary hypopituitarism) or the hypothalamus (secondary hypopituitarism). Depending on the anatomic lesion, patients with hypopituitarism may present with signs or symptoms of multiple endocrine abnormalities, such as hypothyroidism, adrenal insufficiency, diabetes insipidus, hypoglycemia, sexual dysfunction and growth retardation. A thorough clinical history, detailed examination, laboratory evaluation of endocrine function and radiographic views of the pituitary and sella turcica can suggest the diagnosis and etiology. Treatment, usually lifelong, may include hormone replacement and medical or surgical correction of the underlying disease.
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PMID:Hypopituitarism. 204 46

Over the past 12 years we encountered three histologically confirmed pituitary metastases. Primary cancer had been diagnosed and treated previously in only one patient. In the remaining two a transsphenoidal operation provided the initial diagnosis of metastasis, and the primary lesion was subsequently detected at autopsy in one. In two of the three patients symptoms and signs of pituitary dysfunction were the first manifestations of the malignant disease. The main symptoms and signs were impairment of visual acuity, visual field defect, headache, adenohypophyseal insufficency and diabetes insipidus. A sellar mass was demonstrated by CT or MRI in all patients. The tumours were all completely extirpated by subfrontal route in one case and transsphenoidally in the remaining two patients. Following surgery the presenting symptoms improved satisfactorily in all patients.
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PMID:Pituitary metastases. 220 80

We report a case of nasopharyngeal squamous carcinoma complicated by diabetes insipidus and hypercalcaemia. As there was no evidence of bony metastases we conclude that this latter finding was due to a humoral factor produced by the tumour. The management of these problems is discussed.
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PMID:Diabetes insipidus and hypercalcaemia secondary to nasopharyngeal carcinoma. 231 77

Metastatic tumors within the pituitary gland are rare. The incidence--reported by series of autopsies--differs from 1.8-12% of metastatic tumors. Most of the primary tumors are breast cancers, followed by cancers of the gastro-intestinal system. Only 20% of these metastases are clinically diagnosed. Diabetes insipidus is the main symptom, correlating with the greater incidence of metastatic lesions in the posterior lobe. The unusual features of a reported case are discussed. In this case the dysfunction of cranial nerves passing the sella turcica led to the diagnosis. Therapy with Flutamid initiated a remission. Survival of 18 months is remarkably long.
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PMID:[Clinical aspects of hypophyseal metastases]. 304 26

Tumors metastatic to the pituitary gland are uncommon, but may mimic a typical pituitary adenoma and are an important part of the differential diagnosis of sellar mass lesions. Pituitary metastases were treated by transsphenoidal microsurgical removal in 14 patients. Most tumors appeared in men in the sixth and seventh decades of life. Half of the patients presented with visual loss, 6 had anterior hypopituitarism, and 4 had diabetes insipidus. Primary cancer had been diagnosed and treated previously in 5 patients. In the remaining 9 patients, the transsphenoidal operation provided the initial diagnosis of cancer, and primary lesions subsequently were detected in all but 2. Transsphenoidal surgery also provided satisfactory decompression of the mass effect related to the tumors, improving the presenting symptoms in the majority of patients, and the surgery was free of mortality or serious complications.
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PMID:Metastatic tumors of the sella turcica masquerading as primary pituitary tumors. 362 9

Selective adenohypophysectomy, by the injection of up to 1 ml of absolute alcohol to the pituitary gland, was used to produce pain relief in 25 patients suffering from metastatic cancer. Thirty-five treatments were given and good analgesia was obtained in 74%. The median duration of pain relief was 6-7 weeks, although some treatments produced relief for up to 20 months. The procedure was most successful in relieving bone pain in patients with advanced carcinoma of the breast or prostate. The use of a fine-gauge needle for the intranasal trans-sphenoidal approach to the gland and the injection of alcohol to the anterior part (pars distalis) of the gland reduced the frequency of the major complications diabetes insipidus (17%) and prolonged visual disturbance (3%).
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PMID:Selective hypophysectomy for metastatic pain. A review of ethyl alcohol ablation of the anterior pituitary in a Regional Pain Relief Unit. 617 52

Seven cases are presented in which enlargement of the pituitary stalk was demonstrated by computed tomography (CT). Histiocytosis X, sarcoidosis, and metastatic cancer were the proven or presumed causes. The discovery of pituitary stalk enlargement prompted radiation treatment in three patients and led to the diagnosis of previously unsuspected diabetes insipidus in one.
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PMID:CT of the abnormal pituitary stalk. 642 Nov 24

The author reports three young male patients with fairly suddenly developing symptoms of diabetes insipidus preceding by 3-10 months the appearance of extensive neurological changes, with prevailing syndrome of increased intracranial pressure. In 2 cases metastases of bronchial carcinoma to the hypothalamus, occipital lobe and hypophysis were found. The survival time was 3-5 months after the appearance of the first symptoms. In the third patient intracranial pinealoma was diagnosed intravitally and the diagnosis was confirmed by computer tomography, intraoperative inspection and autopsy. The survival time was 15 months after the first symptoms.
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PMID:[Diabetes insipidus as a preliminary sign of brain tumor]. 651 18

Since computerized transaxial tomography (CTT) scanning at the Mayo Clinic (1974-1981), 25 cases of metastatic diabetes insipidus (DI) have been identified. Of 100 consecutive cases of DI of any cause, 14 were due to metastatic cancer. Diabetes insipidus was the initial presentation in 11 patients with systemic cancer. In the 11 patients, the most common sources metastatic to the posterior pituitary-hypothalamic region were lung (3) and the leukemia/lymphoma group (4). Although skull x-ray results were usually normal (9 of 11), CTT scanning results were abnormal in 5 of 11, including demonstration of pituitary stalk enlargement, suprasellar masses, or both. Metastases elsewhere in the nervous system were apparent in four patients. Anterior pituitary and visual system involvement occur in a minority group of patients.
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PMID:Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus. 664 May 7

Tumor metastasis to the posterior pituitary-hypothalamic area rarely is expressed by either clinical or radiographic evidence. A case is reported of widespread metastic ACTH secreting bronchogenic carcinoma presenting to the clinician as diabetes insipidus. This type of tumor associated with diabetes insipidus is apparently rare, as is antemortem radiographic documentation of metastasis to the pituitary--hypothalamic region. A review of the ten-year experience of Loyola University Medical Center and Hines VA Hospital with the association of bronchogenic carcinoma and diabetes insipidus is presented with a brief review of metastic disease to the pituitary.
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PMID:Bronchogenic carcinoma and diabetes insipidus: case report and review. 705 16


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