Table 1.
Clinical features of patients at the time of detection of pituitary metastases, management and outcomes
| Case | Age | Sex | Site of Primary Malignancy | Clinical manifestations | Anterior pituitary hormone deficiencies | DI | Other sites of metastases | Management | Outcome | Time to growth (months) |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 65 | F | Lung | Visual dysfunction (VF defects and CN III palsy) |
FSH/LH-Yes TSH-Yes ACTH-Yes |
No | Yesa: liver, brain (cerebral), spine | Radiotherapy (whole brain) | Regressed | N/A |
| 2 | 53 | F | Breast | Symptoms/signs of cortisol deficiency and VF defects |
FSH/LH-Yes TSH -Yes ACTH-Yes |
No | No | Surgery and adjuvant radiotherapy (whole brain) | Regressed | N/A |
| 3 | 67 | M | Prostate | Visual dysfunction (reduction in VA and VF defects) |
FSH/LH-Yes TSH-No ACTH-No |
No | No | Radiotherapy | Unknown | N/A |
| 4 | 61 | M | Lung | DI | No information | Yes | No | Monitoring | Growth | 3 |
| 5 | 63 | F | Lung | Visual dysfunction (VF defects) |
FSH/LH-Yes TSH-Yes ACTH-Yes |
No | Yesa: adrenal glands, mediastinal lymph nodes | Surgery | Growth | 4 |
| 6 | 50 | F | Breast | Visual dysfunction (VF defects) |
FSH/LH-Yes TSH-No ACTH-no information |
Yes | Yes: lymph nodes, bone, liver | Radiotherapy | Growth | 9 |
| 7 | 64 | F | Melanoma | Visual dysfunction (CN VI palsy) | None | No | Yes: lung, liver, bone, mesentery | Monitoring | Unknown | N/A |
| 8 | 55 | F | Breast | Visual dysfunction (rapid visual loss leading to blindness) |
FSH/LH-Yes TSH-Yes ACTH -Yes |
No | No | Surgery | Unknown | N/A |
| 9 | 62 | F | Lung | Symptoms unrelated to PM (abnormal sensation in R side of face, change in function of left hand) | No information | No | Yesa: brain (thalamus) | Radiotherapy | Unknown | N/A |
| 10 | 56 | F | Melanoma | Visual dysfunction (VF defects) |
FSH/LH-Yes TSH-Yes ACTH-Yes |
No | No | Surgery | Growth | 45 |
| 11 | 74 | F | Breast | Symptoms/signs of cortisol deficiency |
FSH/LH-Yes TSH-no information ACTH-Yes |
Yes | Yes: lung, skin, bone | Monitoring | Unknown | N/A |
| 12 | 75 | M | Renal | Visual dysfunction (CN III and VI palsies and VF dysfunction) |
FSH/LH-Yes TSH-No ACTH-Yes |
No | Yes: lung, pancreas | Monitoring | Growth | 3 |
| 13 | 57 | F | Lung | Symptoms unrelated to PM (ataxia and vomiting) | No information | No | Yesa: adrenal, bone, brain (cerebellum) | Radiotherapy (whole brain) | Unknown | N/A |
| 14 | 73 | F | Lung | Symptoms unrelated to PM (unsteady gait and L sided facial droop) |
FSH/LH-Yes TSH-No ACTH-No |
No | Yes: brain (cerebral) | Monitoring | Growth | 15 |
| 15 | 66 | M | Prostate | Visual dysfunction (CN III palsy) |
FSH/LH-no information TSH-No ACTH-no information |
No | Yes: bone, lymph nodes | Radiotherapy (whole brain) | Regressed | N/A |
| 16 | 59 | F | Lung | Incidental finding during staging imaging | No information | No | Yesa: brain (cerebral) | Radiotherapy (whole brain) | Unknown | N/A |
| 17 | 44 | F | Breast | Symptoms unrelated to PM (seizures) |
FSH/LH-No TSH-No ACTH-No |
No | Yes: bone, brain (cerebral), liver, spleen | Monitoring | Growth | 23 |
| 18 | 55 | F | Breast | Incidental finding during follow-up imaging for a co-existent tentorial meningioma |
FSH/LH-Yes TSH-Yes ACTH-Yes |
No | Yes: bone | Radiotherapy | Unknown | N/A |
VF visual field, VA visual acuity, FSH follicle stimulating hormone, LH luteinizing hormone, ACTH adrenocorticotropic hormone, DI diabetes insipidus, N/A not applicable
aIndicates PM was first manifestation of metastatic disease