Report Of 4 Cases Of Pituitary Metastatic Carcinoma And Literature Review

Objective:To report 4 cases of malignant tumor metastasis to the pituitary,analyze its clinical features and treatment,and improve the clinician's understanding of pituitary metastases.Methods:We retrospectively analyzed of 4 cases of pituitary metastases were diagnosed in Qilu Hospital of Shandong University from 2013 to 2018.The clinical manifestations,laboratory tests,diagnosis and treatment were collected,and the related literatures of pituitary metastases were reviewed.Results:1.Of the 4 patients,2 were male,with lung cancer metastasis and 2 females,all of which were breast cancer metastasis.The age is 53-61 years old.Three patients had symptoms of diuretic symptoms such as polydipsia and polyuria(the symptoms of pituitary metastases were earlier than those of primary lesions).One patient did not complain of symptoms of diabetes mellitus,but had a low specific gravity urine.The imaging technique showed that the pituitary stalk thickened and the posterior lobe high signal showed unclear,and there should be central diabetes insipidus.One patient had dizziness and temporal field defects,one patient had blurred vision,and two patients with pituitary metastases also showed decreased hearing.In 4 patients,there were 3 cases with anterior pituitary function and 3 cases with elevated PRL,all of which were mildly elevated.2.4 patients had saddle area mass lesions,T1 usually had equal or low signal,T2 could be low signal or high signal,enhanced scan 3 cases were uneven enhancement,and 1 case was uniform.In 4 patients,the high signal disappeared in the posterior pituitary and 3 patients had the pituitary stalk thickening.All the 4 cases showed invasiveness in the sellar mass,which was characterized by optic chiasm(2 cases),saddle bone destruction(3 cases)and cavernous sinus involvement(1 case),and 2 cases had other intracranial metastases.3.3 patients were diagnosed with pituitary metastases by biopsy or postoperative biopsy.One patient was highly diagnosed according to symptoms,clinical manifestations,pituitary imaging and whole body imaging.One patient had a total pituitary dysfunction and pituitary enhancement.The characteristics of uniform scan enhancement are treated with hormones in pituitary inflammation.4.The survival of 4 patients was short,from April to December.Conclusion 1.Pituitary metastases occur mostly in middle-aged and elderly people,mainly for lung cancer and breast cancer metastasis.The symptoms of polydipsia,polyuria and other symptoms of diabetes mellitus may be the main or first manifestations,mostly accompanied by anterior pituitary dysfunction,and visual field of vision Symptoms such as obstacles and hearing loss,such as tissue involvement around the pituitary;2.The imaging findings of pituitary metastatic carcinoma are not specific,manifested as saddle-occupying lesions,T1 or other low signal,high signal disappears in the posterior pituitary,and the pituitary stalk is thickened,showing uneven or uniform enhancement.3.The diagnosis of pituitary metastases depends on the pathological examination of the biopsy in the sellar region.4.The treatment of pituitary metastases is limited,the prognosis is poor,and the multidisciplinary diagnosis and treatment model can help improve the prognosis and improve the quality of life.