Metastatic tumors of the pituitary gland as a cause of diabetes insipidus in 4 patients
Journal Title: Family Medicine & Primary Care Review - Year 2013, Vol 15, Issue 3
Abstract
Background. Pituitary metastases occur rarely and are observed mainly in patients with lung and breast cancer.They are twice as common in the nervous part and the stalk as in the glandular area. Objectives. The aim of the paper is to present patients with diabetes insipidus (CDI) caused by metastases to the pituitary, emphasisingthe risk of their occurrence both at the early and advanced stages of cancer. Material and methods. 3 females and 1 male hospitalised in the years 2000–2007 were included in the study. An analysis of linical features and supplementary tests were performed. Results. Female aged 42. Without an earlier diagnosis of cancer; thirst and polyuria of 14 l/day. In MRI fusiform thickening of the pituitary stalk. Cancer of the left breast had been diagnosed only half a year after CDI had been found. Female aged 50. Thirst and diuresis of 7–8 l/day. Lung cancer had been diagnosed in an advanced clinical state. MRI showed metastases in the pituitary (11 x 13 x 18 mm). Female aged 61. She had undergone bilateral mastectomy, as well as chemo- and radiotherapy due to breast cancer. Thirst and polyuria of 6–7 l/day. MRI showed a lack of high signal in the pituitary nervous part. Male aged 74 Polyuria and thirst of about 4 l/day. He had had surgery 4 times due to prostate cancer. In MRI the pituitary size 13 x 18 mm,and there was heterogeneous enhancement after administering the paramagnetic contrast. Summary. In each of the patients the metastasis to the pituitary occurred at a different stage of cancer: a) in the first it was a symptom which preceded the diagnosis, b) in the second it accompanied the spreading of cancer and was diagnosed simultaneously with diabetes insipidus; c) in the third and in the male with prostate cancer is was a symptom of the spreading of malignancy which had been diagnosed earlier. Conclusions. Pituitary metastases can occur at any stage of cancer and should be taken into consideration in every patient with new-onset CDI.
Authors and Affiliations
Maria Kurowska, Joanna Malicka, Jerzy S. Tarach, Marta Dudzińska
Keywords
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