抄録
A 58-year-old female was admitted to the hospital because of loss of consciousness, poor appetite and general malaise. She had had radiation therapy for nasopharyngeal cancer two years before. Serum sodium concentration was 115 mEq/l, and serum cortisol and ACTH levels were extremely low. Endocrinological dynamic tests indicated panhypopituitarism and a pituitary tumor was disclosed by an MRI study. Since metastases were detected nowhere other than the pituitary gland, transsphenoidal subtotal resection of the pituitary tumor was performed. Histological diagnosis was an undifferentiated squamous cell carcinoma. After the operation, carboplatin and fluorouracil were administered. She has since been in good condition with the replacement therapy consisting of 1-thyroxine and cortisone acetate.
A 74-year-old female who had undergone right, upper lobectomy for lung cancer one year before was admitted because of thirst, polydipsia and polyuria. Water deprivation tests revealed partial pituitary diabetes insipidus. Endocrinological tests on the anterior pituitary function indicated multiple disturbances of hormones, including the gonadotropin, the growth hormone and the thyrotropin. She died due to respiratory infection one month after the appearance of her symptoms. Multiple metastases to the lung, liver, kidney and bone were confirmed during autopsy. The pituitary posterior lobe and part of an anterior lobe had been replaced by squamous cell carcinoma.
The metastatic pituitary tumor is relatively rare and most cases are asymptomatic. In these two cases, the metastases to the pituitary gland were diagnosed by endocrinological signs and symptoms. In addition, the prognosis of pituitary metastasis is improved by early and appropriate therapy.
