Diplopia and left palpebral ptosis as a first manifestation of hypophysary metastases of pulmonary adenocarcinoma
Keywords:
Metástasis hipofisarias. Hipogonadismo hipogonadotropo. Diplopía. Cáncer pulmonar.Abstract
A patient, without significant previous medical history, who started with diplopia and left palpebral ptosis as the first manifestation of hypophysary metastases of a widely disseminated and previously undetected cancer of pulmonary origin. Together with a histological study of the lesions, the diagnosis was made with specific image tests of the hypophysary area, which detected a neoformation in the sella turca that was invading the left cavernous sinus with erosion of the verso of the sellar, together with the presence of pulmonary nodules and numerous adenopathies. An hypogonadotropic hypogonadism was detected as the only hormonal alteration due to the infiltration of the anterior hypophysis due to the osseous metastases at the base of the cranium. The patient, in spite of receiving several weeks of radiotherapy, suffered a progressive neurological deterioration and died after a few weeks.Downloads
References
1. MORITA A, MEYER FB, LAWS ER. Symptomatic pituitary metastases. J Neurosurg 1998; 89: 69-73.
https://doi.org/10.3171/jns.1998.89.1.0069
2. FRAGO MARQUÍNEZ I, FUENTES GÓMEZ C, MALDONADO CASTRO M, PUELLES EMALDIBARRA N, SAN MIGUEL LÓPEZ DE URRALDE S, ECHEVESTE AIZPURUA J et al. Metástasis hipofisarias en pacientes con antecedentes neoplásicos. Endocrinol Nutr 2009; 56: 265-269.
https://doi.org/10.1016/S1575-0922(09)71410-X
3. KOMNINOS J, VLASSOPOULOU V, PROTOPAPA D, KORFIAS S, KONTOGEORGOS G, SAKAS DE et al. Tumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab 2004; 89: 574-580.
https://doi.org/10.1210/jc.2003-030395
4. PRODAM F, PAGANO L, BELCASTRO S, GOLISANO G, BUSTI A, SAMÁ M et al. Pituitary metastases from follicular thyroid carcinoma. Thyroid 2010; 20: 823-830.
https://doi.org/10.1089/thy.2009.0256
5. AZAMBUJA E, PICCART MJ, AWADA A. Long-term survival in pituitary metastasis from breast cancer. Breast 2006; 15: 446-447.
https://doi.org/10.1016/j.breast.2005.06.007
6. FASSET DR, COULDWELL WT. Metastases to the pituitary gland. Neurosurg Focus 2004; 16: E8.
https://doi.org/10.3171/foc.2004.16.4.9
7. LÓPEZ-MONDÉJAR P, MASSUTI B, PARDO C, MORENO O, AZNAR S, PICÓ A. Panhipopituitarismo secundario a metástasis hipofisaria de adenocarcinoma esofágico. Endocrinol Nutr 2004; 51: 133-135.
https://doi.org/10.1016/S1575-0922(04)74598-2
8. NASR C, MASON A, MAYBERG M, STAUGAITIS SM, ASA SL. Acromegaly and somatotroph hyperplasia with adenomatous transformation due to pituitary metastasis of a growth hormone-releasing hormone-secreting pulmonary endocrine carcinoma. J Clin Endocrinol Metab 2006; 91: 4776-4780.
https://doi.org/10.1210/jc.2006-0610
9. Ko JC, YANG PC, HUANG TS, YEH KH, KUO SH, LUH KT. Panhypopituitarism caused by solitary parasellar metastasis from lung cancer. Chest 1994; 105: 951-953.
https://doi.org/10.1378/chest.105.3.951
10. GUERRA ALÍA E, GARRIDO LÓPEZ P, PACHÓN OLMOS V, MEDINA MARTÍNEZ J, GONZÁLEZ MARTÍN A, VAL SALGADO MA. Hipopituitarismo secundario debido a metástasis en región hipotalámica de carcinoma microcítico de pulmón. Endocrinol Nutr 2009; 56: 201-204.
https://doi.org/10.1016/S1575-0922(09)70985-4
11. ITO I, ISHIDA T, HASHIMOTO T, ARITA M, OSAWA M, YOKOTA T et al. Hypopituitarism due to pituitary metastasis of lung cancer: case of a 21-year-old man. Intern Med 2001; 40: 414-417.
https://doi.org/10.2169/internalmedicine.40.414
12. KRAMER CK, FERREIRA M, SILVEIRO SP, GROSS JL, DORA JM, AZEVEDO MJ. Pituitary gland metastasis from renal cell carcinoma presented as a non-functioning macroadenoma. Arq Bras Endocrinol Metabol 2010; 54: 498-501.
Published
How to Cite
Issue
Section
License
Copyright (c) 2012 Anales del Sistema Sanitario de Navarra
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
