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

The case of a previously healthy 63-year-old female with metastatic adenocarcinoma to the hypothalamus presenting with central diabetes insipidus is presented. The patient was found to have metastatic disease isolated to her hypothalamus on brain magnetic resonance imaging as well as a water deprivation test consistent with central diabetes insipidus. The patient had a decrease in symptoms of polyuria and polydypsia as well as a decrease in urine volumes after treatment with intranasal vasopressin. Even though a rare occurrence, physicians should consider metastatic adenocarcinoma in patients with recent-onset polyuria and polydypsia.
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PMID:Metastatic adenocarcinoma presenting with central diabetes insipidus. 961 23

Nephrogenic diabetes insipidus was diagnosed in a dog with an intestinal leiomyosarcoma. The diagnosis of nephrogenic diabetes insipidus was made on the basis of results of serum biochemical tests, urinalyses, and a water-deprivation test, along with a lack of response to exogenous administration of vasopressin following the water-deprivation test. The temporal association between resection of the intestinal mass and resolution of clinical signs of diabetes insipidus (i.e., polyuria and polydipsia) and between recurrence of clinical signs and detection of metastatic disease suggests that there may have been a causal relationship, and nephrogenic diabetes insipidus may have developed as a paraneoplastic syndrome in this dog.
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PMID:Nephrogenic diabetes insipidus in a dog with intestinal leiomyosarcoma. 1061 14

We describe a 35-year-old woman who presented with diabetes insipidus caused by metastatic papillary carcinoma of the thyroid involving the pituitary gland, 25 years after treatment for a papillary carcinoma of thyroid and 17 years after treatment for multiple pulmonary metastases. The literature contains 10 previously described cases of metastatic thyroid carcinoma involving the sella, but only 2 of these cases had unequivocal metastases to the pituitary gland, making the present case, to our knowledge, the third reported case of unequivocal hematogenous metastasis of thyroid carcinoma to the pituitary gland. The pituitary tumor was removed by transsphenoidal surgery, and the tissue was examined by conventional histology, extensive immunohistochemistry, and electron microscopy. The findings confirmed the tumor to be papillary thyroid carcinoma. To our knowledge, this is the first report citing use of thyroid transcription factor-1 to establish a thyroid source of a pituitary metastasis.
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PMID:Papillary carcinoma of thyroid metastatic to the pituitary gland. 1141 81

Metastatic tumors of the pituitary gland are uncommon. The majority of them are silent lesions incidentally discovered at autopsy. In contrast, the occurrence of symptomatic metastases is exceptional. Here we report the clinical and radiological findings of a 45 year-old woman with a metastatic lung adenocarcinoma who presented with diabetes insipidus and hypernatremic dehydration. There was no previous history of malignancy, and the pituitary metastases were responsible for the first manifestation of the disease. Clinical presentation, diagnosis and therapeutic management of patients with pituitary metastases are reviewed.
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PMID:[Central diabetes insipidus as clinical presentation of a bronchogenic adenocarcinoma]. 1153 24

Pituitary stalk thickening has a wide differential diagnosis, but almost all infundibular diseases present with diabetes insipidus (DI). We present a child with metastatic involvement of the pituitary stalk from a primary pontine tumour and a child with tuberculous infiltration of the pituitary stalk and associated meningeal inflammation. Neither child presented with DI. Even though both metastatic disease and tuberculous infiltration of the stalk have been reported in adults, these are the first reports with accompanying cross-sectional images of pituitary stalk involvement by these diseases in children.
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PMID:Two unusual causes of pituitary stalk thickening in children without clinical features of diabetes insipidus. 1281 37

Pituitary stalk involvement is seen in a variety of medical conditions such as infectious diseases, infiltrative diseases and tumors (intracranial and metastatic). Metastatic cancer has a greater propensity to involve the infundibulum and neurohypophysis. We report a case of a 68-year-old man who presented with thickening of the stalk, panhypopituitarism, diabetes insipidus and generalized lymphadenopathy. Lymphoma was diagnosed on axillary lymph node biopsy and lymphomatous involvement of the infundibulum was suspected. Although infundibular thickening resolved and diabetes insipidus improved after chemotherapy, panhypopituitarism persisted.
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PMID:A rare cause of pituitary stalk enlargement and panhypopituitarism. 1296 99

We describe a 61-year-old woman with diabetes insipidus caused by a pituitary stalk metastasis from breast cancer. She had a medical history of breast conservation therapy for early breast cancer 5 years previously. Pituitary, lung, liver, bone and neck lymphnode metastases was revealed at the same time. She received systemic chemotherapy consisting of docetaxel and cisplatin. After chemotherapy MRI finding in pituitary gland was improved, lung and liver metastases also improved, however, symptoms of diabetes insipidus did not improve. She is alive, receiving endocrine treatment for 2 years, since onset of diabetes insipidus.
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PMID:Pituitary stalk metastasis from breast cancer treated with systemic chemotherapy. 1453 28

In a 45-year-old man with a hypernephroma tumor of the right kidney, a metastasis in the pituitary gland of this neoplasm was diagnosed 9 years after removal of this kidney. He complained of bitemporal hemianopsia and slight impairment of vision. A hypernephroma metastasis in the pituitary gland is very rare and few have been reported to date. In general, these metastases occur in cases with multiple metastasis to many organs, which suggests that the appearance of pituitary metastasis represents extensive disease. Many of these patients present diabetes insipidus. Visual defects are frequently associated. The Goldmann perimeter is important to detect visual field anomalies. MRI is the key radiological exam to localize the tumor. Surgery is the preferred treatment and should be undertaken quickly if visual function is affected. The histological exam should be made to confirm the diagnosis.
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PMID:[Hypophysis metastasis of a hypernephroma tumor revealed by a chiasma syndrome]. 1463 Dec 84

Three cases of pituitary metastases were reported. They all had operations and the pathological examination confirming the diagnosis. The clinical features of diabetes insipidus and extraocular nerve palsy were presented. In two cases, the original tumors were bronchioloalveolar carcinoma; in the other one, the original tumor was unknown. All three cases had poor outcome. These cases illustrate the fact that a pituitary metastasis can closely mimic a pituitary benign tumor, such as pituitary adenoma. Especially in the presence of suggestive symptoms such as diabetes insipidus and/or cranical nerve paralysis, the possibility of metastatic disease in the differential diagnosis of a pituitary mass should always be considered.
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PMID:Diagnosis and treatment of the pituitary metastases. 1510 30

Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.
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PMID:Metastases to the pituitary gland. 1519 37


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