転移性下垂体腫瘍 : その病態と診断, 治療

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Four cases of symptomatic metastatic pituitary tumors are presented and the pertinent literature on the management of secondary tumors of the pituitary region is reviewed. Of the 4 cases, 2 had metastases from breast carcinoma, one had pituitary metastasis from liposarcoma of the leg, and one had direct invasion of nasopharyngeal squamous cell carcinoma to the clival and pituitary region. Two cases presented panhypopituitarism and in all cases rapidly deteriorating cranial nerve palsies were noticed. Contrast-enhanced computerized tomography scan precisely demonstrated the pituitary metastatic lesions in all cases. Transsphenoidal microsurgical tumor resections were performed in 3 cases. Visual disturbance observed in one was markedly improved after surgery. Cranial nerve palsies subsided completely in all cases after radiotherapy. Metastases of malignant tumors to the pituitary region are not uncommon in postmortem examinations or in cases with hypophysectomy performed to treat advanced breast carcinoma. However, the majority of metastatic pituitary tumors are asymptomatic. Recently some authors reported a few cases which presented diabetes insipidus, anterior pituitary insufficiency or cranial nerve palsies as observed in these cases. In such cases, early recognition and radiotherapy will significantly improve the prognosis. When the cases has single metastasis or breast carcinoma metastasis, or presents visual field defect, transsphenoidal tumor resection is also assumed to be an effective treatment.
日本脳神経外科学会の論文
1987-05-15

転移性下垂体腫瘍 : その病態と診断, 治療

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