Generic placeholder image

Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Isolated Pituitary Metastasis of Renal Cell Carcinoma: A Case Report and Systematic Review of the Literature

Author(s): Bala Başak Öven, Mustafa Kemal Demir*, Serkan Çelik, Riad Moujawaz, Adnan Somay and Turker Kılıc

Volume 18, Issue 13, 2022

Published on: 04 August, 2022

Page: [1426 - 1432] Pages: 7

DOI: 10.2174/0929866529666220426121245

Price: $65


Background: Isolated pituitary gland metastasis is an extremely rare event in renal cell carcinoma. We present a unique case of isolated pituitary metastasis of renal cell carcinoma and a systematic review of literature on it.

Case Report: In this case, an abdominal ultrasound in an asymptomatic 51-year-old female patient showed a mass in her left kidney. Radical nephrectomy was performed and the tumor was diagnosed as a stage 1 clear cell carcinoma. Throughout the 3 months of the follow-up period, the patient started complaining of visual disturbances and headaches. A pituitary mass was found on brain magnetic resonance imaging and was suspected to be a macroadenoma. Surgical resection of the tumor was performed and the final pathological diagnosis was made as a pituitary metastasis of the renal cell carcinoma. After surgery, radiotherapy with sunitinib, a receptor tyrosine inhibitor, was performed.

Conclusion: The clinical symptoms are usually related to the mass effect of the tumor and anterior pituitary involvement. Most of the cases mimic pituitary macroadenoma on MRI. The most preferred treatment combination is surgery and radiotherapy. We recommend adding sunitinib to this combination. This illustrative case and those found in a systematic review of the literature highlight the importance of histopathologic diagnosis and appropriate management since isolated pituitary metastasis is challenging to preoperative diagnosis.

Keywords: Pituitary metastasis, renal cell carcinoma, magnetic resonance imaging, treatment, Oncology, radiotherapy, surgery.

Graphical Abstract
Fassett DR, Couldwell WT. Metastases to the pituitary gland. Neurosurg Focus 2004; 16(4): E8.
Shimon I. Metastatic Spread to the Pituitary. Neuroendocrinology 2020; 110(9-10): 805-8.
[] [PMID: 32101869]
Sahel OA, Benameur Y, Nabih SO, Biyi A, Doudouh A. A rare case of pituitary metastasis from breast cancer detected on fluorodeoxyglucose positron emission tomography/computed tomography that presented as insipid diabetes. World J Nucl Med 2020; 20(2): 211-4.
[] [PMID: 34321980]
Wong AK, Close TW, Wong RH. Osimertinib-induced rapid regression of large metastatic tumor to the pituitary in a patient with lung ade-nocarcinoma. Surg Neurol Int 2021; 12: 13.
[] [PMID: 33500828]
Riemenschneider MJ, Beseoglu K, Hänggi D, Reifenberger G. Prostate adenocarcinoma metastasis in the pituitary gland. Arch Neurol 2009; 66(8): 1036-7.
[] [PMID: 19667229]
Ozturk MA, Eren OO, Sarikaya B, Aslan E, Oyan B. Pituitary metastasis of colon adenocarcinoma: A rare occurrence. J Gastrointest Cancer 2014; 45(Suppl. 1): 85-7.
[] [PMID: 24158699]
Komninos J, Vlassopoulou V, Protopapa D, et al. Tumors metastatic to the pituitary gland: Case report and literature review. J Clin Endocrinol Metab 2004; 89(2): 574-80.
[] [PMID: 14764764]
Murrone D, Abbate FA, De Paulis D, Galzio RJ. Pituitary gland metastases from renal cell carcinoma: A case report and literature update. Integr Cancer Sci Therap 2015; 2: 208-10.
Wendel C, Campitiello M, Plastino F, et al. Pituitary metastasis from renal cell carcinoma: Description of a case report. Am J Case Rep 2017; 18: 7-11.
[] [PMID: 28044054]
Bišof V, Juretić A, Šarić N, Melada A, Perković Z, Radoš M, et al. Pituitary metastasis of renal cell carcinoma: A case report. Radiol Oncol 2008; 42(2): 225-31.
Moon RDC, Singleton WGB, Smith P, Urankar K, Evans A, Williams AP. Slow-growing pituitary metastasis from renal cell carcinoma: Lit-erature review. World Neurosurg 2021; 145: 416-25.
[] [PMID: 32891842]
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA Statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med 2009; 6: e1000100.
Buonaguidi R, Ferdeghini M, Faggionato F, Tusini G. Intrasellar metastasis mimicking a pituitary adenoma. Surg Neurol 1983; 20(5): 373-8.
[] [PMID: 6635925]
James RL Jr, Arsenis G, Stoler M, Nelson C, Baran D. Hypophyseal metastatic renal cell carcinoma and pituitary adenoma. Case report and review of the literature. Am J Med 1984; 76(2): 337-40.
[] [PMID: 6695956]
Eick JJ, Bell KA, Stephan MT, Fuselier HA Jr. Metastatic renal cell carcinoma presenting as an intrasellar mass on computerized tomography. J Urol 1985; 134(1): 128-30.
[] [PMID: 4009805]
Nishio S, Tsukamoto H, Fukui M, Matsubara T. Hypophyseal metastatic hypernephroma mimicking a pituitary adenoma. Case report. Neurosurg Rev 1992; 15(4): 319-22.
[] [PMID: 1480281]
Beckett DJ, Gama R, Wright J, Ferns GA. Renal carcinoma presenting with adrenocortical insufficiency due to a pituitary metastasis. Ann Clin Biochem 1998; 35(Pt 4): 542-4.
[] [PMID: 9681058]
Pallud J, Nataf F, Roujeau T, Roux FX. Intraventricular haemorrhage from a renal cell carcinoma pituitary metastasis. Acta Neurochir (Wien) 2005; 147(9): 1003-4.
[] [PMID: 16041465]
Mori Y, Kobayashi T, Shibamoto Y. Stereotactic radiosurgery for metastatic tumors in the pituitary gland and the cavernous sinus. J Neurosurg 2006; 105: 37-42.
Gołkowski F, Trofimiuk M, Czepko R, et al. Two rare cases of pituitary metastases from breast and kidney cancers. Exp Clin Endocrinol Diabetes 2007; 115(8): 537-40.
[] [PMID: 17853340]
Gopan T, Toms SA, Prayson RA, Suh JH, Hamrahian AH, Weil RJ. Symptomatic pituitary metastases from renal cell carcinoma. Pituitary 2007; 10(3): 251-9.
[] [PMID: 17541748]
Grossman R, Maimon S, Levite R, Ram Z. Multimodal treatment of hemorrhagic pituitary metastasis as first manifestation of renal cell carcinoma. World Neurosurg 2013; 79: 798.E1-5.
Zoli M, Mazzatenta D, Faustini-Fustini M, Pasquini E, Frank G. Pituitary metastases: Role of surgery. World Neurosurg 2013; 79(2): 327-30.
[] [PMID: 22480977]
Shen Z, Yang C, Bao X, Wang R. Giant sellar metastasis from renal cell carcinoma: A case report and literature review. Medicine (Baltimore) 2018; 97(47): e13376.
[] [PMID: 30461658]
Elkassem AA, Allen BC, Sharbidre KG, Rais-Bahrami S, Smith AD. Update on the role of imaging in clinical staging and restaging of renal cell carcinoma based on the AJCC 8th edition, from the AJR special series on cancer staging. AJR Am J Roentgenol 2021; 217: 541-55.
Koshimoto Y, Maeda M, Naiki H, Nakakuki K, Ishii Y. MR of pituitary metastasis in a patient with diabetes insipidus. AJNR Am J Neuroradiol 1995; 16(4)(Suppl.): 971-4.
[PMID: 7611088]
Morita A, Meyer FB, Laws ER Jr. Symptomatic pituitary metastases. J Neurosurg 1998; 89(1): 69-73.
[] [PMID: 9647174]
McCormick PC, Post KD, Kandji AD, Hays AP. Metastatic carcinoma to the pituitary gland. Br J Neurosurg 1989; 3(1): 71-9.
[] [PMID: 2789715]
Leca BM, Mytilinaiou M, Tsoli M, et al. Identification of an optimal prolactin threshold to determine prolactinoma size using receiver operating characteristic analysis. Sci Rep 2021; 11(1): 9801.
[] [PMID: 33963239]
Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol 2016; 70(1): 93-105.
[] [PMID: 26935559]
Ravaud A, Motzer RJ, Pandha HS, et al. Adjuvant sunitinib in high-risk renal-cell carcinoma after nephrectomy. N Engl J Med 2016; 375(23): 2246-54.
[] [PMID: 27718781]

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy