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

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

A 64-year-old woman experienced an episode of disorientation in relation to time, place, and people, as well as of visual defect and impaired balance. Physical examination showed a bitemporal hemianopsia and truncal ataxia. Computerized tomography of the skull revealed a sellar mass consistent with the diagnosis of pituitary adenoma. The patient progressively lost consciousness and died. At postmortem examination, a pituitary neoplasm with arachnoid metastases was present. Metastatic cervical lymph nodes were also detected. Histologic aspects of the primary tumor and of lymph node metastases were quite similar. Immunohistochemical investigation revealed the epithelial origin of the neoplasm and failed to disclose endocrine activity. At ultrastructural examination, the cells of the primary tumor and of the metastases lacked specific granules. These findings support the evidence of a primary metastasizing pituitary carcinoma.
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PMID:Endocrine inactive pituitary carcinoma metastasizing to cervical lymph nodes: a case report. 381 1

A retrospective study was undertaken of 1005 normal contrast-enhanced head computed tomographic (CT) scans in children to determine normal standards for pituitary stalk diameter, basilar artery diameter, and their ratio for age and gender. The pituitary stalk enlarges with age, and girls have larger stalks than do boys after age 8. The pituitary stalk-to-basilar artery ratio is easily estimated visually. Ratios greater than or equal to 1 are unusual in normal children. A ratio greater than or equal to 1 should prompt direct measurement of the stalk and comparison with age-matched normal values. If the stalk measurement is greater than 2 SD above the age-matched mean, it is presumably abnormal and deserves further evaluation for numerous possible pathologic conditions including histiocytosis X, pituitary adenoma, hypothalamic lesions, Rathke cleft cysts, metastases, sarcoidosis, hypothyroidism, and infection.
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PMID:Normal pituitary stalk size in children: CT study. 387 41

A 48-year-old woman developed multiple intracranial and intraspinal metastases from an invasive growth hormone-secreting pituitary adenoma after surgery and radiation therapy. This is the first reported case to show that the cells in the metastatic tumors and in the cerebrospinal fluid contained growth hormone.
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PMID:Intracranial and intraspinal dissemination from a growth hormone-secreting pituitary tumor. Case report. 394 37

To establish a more reasonable therapeutic guide line for large and/or invasive pituitary adenomas, 257 cases of pituitary adenoma were analyzed. Among 83 cases with slight or moderate suprasellar extension (Wilson's Grade II-A & B) in the pre-CT era, 57 patients were alive at the time of follow-up (mean follow-up period: 12.7 years). Death of unspecified causes other than cancer, myocardial infarction, etc. were reported in nine patients. Among 60 cases of Grade II-A & B in the post-CT era, 59 patients were alive (mean follow-up: 3.4 years). Comparing these groups, cases with huge suprasellar extension (Grade C) had much worse prognosis. Only two patients were alive among 14 cases of Group C in the pre-CT era. Seven cases of death with unspecified causes were reported. In the 13 cases of Group C in the post-CT era, 12 patients were alive but at least four of them were severely handicapped. In 10 cases with sphenoid invasion (Grade IV) in the pre-CT era, only two were alive. In the group of Grade IV in the post-CT era, one patient died and three patients were operated repeatedly. Severe complications of irradiation therapy occurred in seven patients (mean interval: 6.6 years) among 120 cases of irradiated pituitary adenomas in every category. Among six cases with histological malignancy, three were operated repeatedly; among the latter group, two patients died and the third showed intracranial metastases. The present data indicate that large and/or invasive pituitary adenomas have a pessimistic prognosis, although adenomas with mild or moderate simple suprasellar extension have fairly good prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical analysis of large and/or invasive pituitary adenomas]. 408 52

A 35-yr-old woman had Cushing's syndrome, amenorrhea, and elevated and nonsuppressible levels of urinary and plasma cortisol and urinary 17-hydroxycorticosteroids. An ovarian carcinoma with extensive metastases was found. Tumor concentrations of ACTH were much lower than those in any previously reported patient with the ectopic ACTH syndrome. Cortisol levels obtained from the venous effluent of tumor-involved ovaries were higher than that in peripheral plasma obtained at the same time. Transient postoperative normalization of plasma and urinary cortisol followed partial tumor removal. Electron microscopic study of the tumor revealed a cell type consistent with steroid-secreting cells. Postmortem examination revealed atrophy of both adrenal glands and no pituitary adenoma.
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PMID:Cushing's syndrome secondary to ectopic cortisol production by an ovarian carcinoma. 630 83

The authors report the case of a 28 year old patient with a prolactin and somatotropin secreting pituitary adenoma who presented several months later with lobular carcinoma of the breast with lymph node metastases. This case raises the question of the role of prolactin and growth hormone in the pathogenesis and growth of breast cancer. It is noteworthy, in particular, because of the exceptional clinical manifestations.
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PMID:[Association of lobular epithelioma and hypophyseal adenoma in a young woman. A case report]. 653 47

In a period of 15 months in a material of 235 surgically verified brain tumours in 8 cases (3.4%) hemorrhages into the tumour mass were found. In 3 of these cases the tumours were anaplastic astrocytomas, the remaining tumours were: oligodendroglioma, meningioma, pituitary adenoma and metastases of renal carcinoma and skin melanoma. The clinical manifestations associated with haemorrhage are discussed stressing that haemorrhage into the tumour worsened the prognosis.
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PMID:[Spontaneous hemorrhage in brain tumors]. 664 30

A case is reported in which a fibrosarcoma developed 20 years after irradiation of a pituitary chromophobe adenoma. This rare lesion, like most of the other documented postirradiation pituitary sarcomas, was a combination of fibrosarcoma and pituitary adenoma. These lesions tend to behave in a characteristic fashion, with onset after a long latent interval following irradiation, growth to a large size, and failure to metastasize.
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PMID:Postirradiation sarcomatous transformation of a pituitary adenoma: a combined pituitary tumor. Case report. 705 40

A 59-year-old male patient was transnasally operated on because of a pituitary adenoma with hypopituitarism. A second operation and X-ray therapy followed a half year later due to recurrent tumor. Both neoplasmas were classified as sparsely granulated prolactin cell adenomas. Immunohistochemical studies revealed strong immunoreactivity for prolactin and FSH in the tumor cells of both the pituitary adenoma and the recurrent tumor. Two years later the prolactin plasma levels were extremely elevated. A tumor in the liver was identified. Biopsy revealed a solid endocrine tumor containing prolactin by immunohistology. Due to structural and immunohistological similarities this tumor could be identified as a metastasis of the pituitary tumor. After 5 months of therapy the patient died from thrombembolism. Post-mortem studies confirmed the diagnosis of a metastasizing prolactin-secreting pituitary carcinoma. Only six similar cases have been reported in the literature. Our case report confirms the experience with 35 definite pituitary carcinomas reparted in the current literature: malignant pituitary tumors develop after pituitary surgery and can be identified not from the pituitary tumor, but only from its metastases.
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PMID:[Prolactin producing hypophyseal carcinoma. Case report of an extremely rare metastatic tumor]. 747 9


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